Most Relevant Information
Provider Data
| NPI Number: | 1003066325 |
| Provider Name: | JACK DAVID MARKIEWICZ M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 2085R0202X |
| Specialty: | Radiology |
| License Number: | 01072267A |
Most Important Dates
| Enumeration Date: | 09/23/2008 |
| Last Updated: | 10/17/2014 |
Provider Practice Location
550 UNIVERSITY BLVD
INDIANAPOLIS
IN
462025149
Practice Location Phone/Fax
| Phone: | 3172789729 |
| Fax: |
Provider Mailing Location
1007 LINCOLNWAY
LA PORTE
IN
463503201
Provider Mailing Phone/Fax
| Phone: | 2193262305 |
| Fax: | 2193262605 |