Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 01069885 | IN |
NPI | 1093981342 |
---|---|
Provider Name | Mark D Ayers |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-5272 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2008 |
Last Update Date | 20/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201117020 | (05) | IN |