Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 01067558A | IN |
N | 207PE0004X | Emergency Medical Services | 4301076539 | MI |
NPI | 1205893484 |
---|---|
Provider Name | Dr. Christopher M Scipione |
First Address | Bloomington, IN 47402-1329 |
Second Address | Paoli, IN 47454-9672 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2006 |
Last Update Date | 30/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200967600 | (05) | IN |
4931828 | (05) | MI |
4931837 | (05) | MI |
4931846 | (05) | MI |
CS076539 | BLUE CROSS BLUE SHIELD (01) | MI |
I65646 | (02) |