Provider Demographics
NPI:1912929266
Name:ENSLEY, DAVID (MD PC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ENSLEY
Suffix:
Gender:M
Credentials:MD PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7855 S EMERSON AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8668
Mailing Address - Country:US
Mailing Address - Phone:317-887-9800
Mailing Address - Fax:317-887-9802
Practice Address - Street 1:7855 S EMERSON AVE
Practice Address - Street 2:SUITE D
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8668
Practice Address - Country:US
Practice Address - Phone:317-887-9800
Practice Address - Fax:317-887-9802
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01052067A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200275530Medicaid
IN000000312814OtherANTHEM
IN200275530Medicaid
IN214080AMedicare PIN