Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 01071196A | IN |
NPI | 1033308275 |
---|---|
Provider Name | Matthew Turner |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-5112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2007 |
Last Update Date | 20/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201067590 | (05) | IN |