| Central Indiana Medical Group | |
|
360 S Madison Ave #200 Greenwood IN 46142-3150 | |
| (317) 865-9090 | |
| (317) 865-0523 |
| Full Name | Central Indiana Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 360 S Madison Ave, Greenwood, Indiana |
| Authorized Official Name and Position | Brenda R Russell (PHYSICIAN) |
| Authorized Official Contact | 3178659090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Indiana Medical Group 1350 E County Line Rd Suite I Indianapolis IN 46227-0873 Ph: (317) 865-9090 | Central Indiana Medical Group 360 S Madison Ave #200 Greenwood IN 46142-3150 Ph: (317) 865-9090 |
| NPI Number | 1790886844 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 06/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790886844 | NPI | - | NPPES |
| 5457630003 | Other | IN | DME |
| CI4722 | Other | IN | GROUP RR MEDICARE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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› Verified 6 days ago
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