Mateo Blair

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Indianapolis, IN

NPI 1750116026 · NPPES record last updated Sep 5, 2024

Key facts

NPI
1750116026
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
910 Fayette St
Indianapolis, IN 46202-3019
Phone
(224) 616-8866
NPI assigned
Sep 5, 2024
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

910 Fayette St
Indianapolis, IN 46202-3019

Mailing address

910 Fayette St
Indianapolis, IN 46202-3019

Other providers in Indianapolis, IN

All providers in Indianapolis, IN · Student in an Organized Health Care Education/Training Program in Indiana

Sources for this page

Verify at the official NPI Registry.