Basic Information
| Provider Information | |||||||||
| NPI: | 1457700510 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEI | ||||||||
| FirstName: | CYNTHIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8326 NAAB RD | ||||||||
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| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462601920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178710011 | ||||||||
| FaxNumber: | 3178704552 | ||||||||
| Practice Location | |||||||||
| Address1: | 1120 W MICHIGAN ST # CL630 | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462025209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172782689 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2016 | ||||||||
| LastUpdateDate: | 07/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 01082362A | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 390200000X | 11018876A | IN | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.