Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 01052171A | IN |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 01052171A | IN |
NPI | 1861426405 |
---|---|
Provider Name | Dr. Brett Ryan Fink |
First Address | Indianapolis, IN 46250-2805 |
Second Address | Indianapolis, IN 46229-2664 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 03/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000764708 | ANTHEM (01) | IN |
200258150 | (05) | IN |
G81014 | (02) | IN |
P01133604 | MEDICARE RAILROAD (01) | IN |