Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 01039976 | IN |
NPI | 1114021615 |
---|---|
Provider Name | Charles G Njinimbam |
First Address | Indianapolis, IN 46206-1026 |
Second Address | Indianapolis, IN 46202-5306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 11/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1510091 | (05) | TN |
200229850 | (05) | IN |