Most Relevant Information
Provider Data
| NPI Number: | 1003073651 |
| Provider Name: | BRYAN JAMES DICKEN M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | 11013942A |
Most Important Dates
| Enumeration Date: | 05/21/2008 |
| Last Updated: | 05/21/2008 |
Provider Practice Location
8015 ENGLEWOOD RD
INDIANAPOLIS
IN
462402729
Practice Location Phone/Fax
| Phone: | 3174058046 |
| Fax: |
Provider Mailing Location
8015 ENGLEWOOD RD
INDIANAPOLIS
IN
462402729
Provider Mailing Phone/Fax
| Phone: | 3174058046 |
| Fax: |