Provider Demographics
NPI:1508039165
Name:PUBLIC SAFETY MEDICAL SERVICES
Entity Type:Organization
Organization Name:PUBLIC SAFETY MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:MOFFATT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-972-1180
Mailing Address - Street 1:324 E. NEW YORK STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-2141
Mailing Address - Country:US
Mailing Address - Phone:317-972-1180
Mailing Address - Fax:317-972-1190
Practice Address - Street 1:324 E NEW YORK ST
Practice Address - Street 2:SUITE 300
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-2141
Practice Address - Country:US
Practice Address - Phone:317-972-1180
Practice Address - Fax:317-972-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01034446OtherINTERNAL MEDICINE