Provider Demographics
NPI:1548785116
Name:NEPHROLOGY & INTERNAL MEDICINE, INC.
Entity Type:Organization
Organization Name:NEPHROLOGY & INTERNAL MEDICINE, INC.
Other - Org Name:NEPHROLOGY & INTERNAL MEDICINE INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-924-8425
Mailing Address - Street 1:5510 S EAST ST STE H
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-1938
Mailing Address - Country:US
Mailing Address - Phone:317-924-8425
Mailing Address - Fax:317-924-8424
Practice Address - Street 1:5540 S. EAST STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-4622
Practice Address - Country:US
Practice Address - Phone:317-924-8425
Practice Address - Fax:317-634-0921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-04
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical