Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 01027959A | IN |
NPI | 1003891573 |
---|---|
Provider Name | Michael Turner |
First Address | Indianapolis, IN 46260-5924 |
Second Address | Indianapolis, IN 46202-2207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 26/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100318380 | (05) | IN |
E05231 | (02) | IN |