Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 01025779 | IN |
NPI | 1043214034 |
---|---|
Provider Name | Dr. David V Poer |
First Address | Indianapolis, IN 46260-5306 |
Second Address | Indianapolis, IN 46260-5306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 19/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000085332 | ANTHEM PIN (01) | IN |
100071570 | (05) | IN |
180001035 | RAILROAD MEDICARE (01) | IN |
B28395 | (02) | IN |