Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 01024467A | IN |
NPI | 1013914118 |
---|---|
Provider Name | Dr. Michael Francis Elmore |
First Address | Indianapolis, IN 46237-8632 |
Second Address | Indianapolis, IN 46237-8632 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 09/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100365930 | (05) | IN |
D94536 | (02) | |
D94536 | (02) | IN |