Provider Demographics
NPI:1770107450
Name:TESOLIN-GEE, AMY (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:TESOLIN-GEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9103 FOGGY CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-6105
Mailing Address - Country:US
Mailing Address - Phone:989-513-5701
Mailing Address - Fax:
Practice Address - Street 1:355 W 16TH ST STE 4300
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2394
Practice Address - Country:US
Practice Address - Phone:317-963-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-29
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11021912A390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program