Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 01084434A | IN |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 30640 | SC |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 35084914 | OH |
N | 207YP0228X | Pediatric Otolaryngology | 30640 | SC |
NPI | 1184661340 |
---|---|
Provider Name | Christopher M Discolo |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-5109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 21/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I40634 | (02) | OH |