Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 01082543A | IN |
Y | 111NI0900X | Internist | 01082543A | IN |
NPI | 1003202763 |
---|---|
Provider Name | Cristina Nancy Perez Chumbiauca |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-5149 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2015 |
Last Update Date | 03/09/2021 |