Individual
ANGELA G PENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9998 CROSSPOINT BLVD STE 200, INDIANAPOLIS, IN 46256-3307
(317) 579-2150
(317) 579-2130
Mailing address
9998 CROSSPOINT BLVD, STE 200, INDIANAPOLIS, IN 46256-3307
(317) 579-2150
(317) 579-2130
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01046191A
IN
2085R0202X
Diagnostic Radiology Physician
1046191
IN
2085R0204X
Vascular & Interventional Radiology Physician
01046191A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000219647
ANTHEM
IN
05
—
200197350A
—
IN
01
—
300131511
RAILROAD MEDICARE
IN
01
—
P00032457
RR MEDICARE PIN
—
01
—
P00032458
RR MEDICARE PIN
—
01
—
P00032459
RR MEDICARE PIN
—
01
—
P00032507
RR MEDICARE PIN
—
01
—
P00032639
RR MEDICARE PIN
—
01
—
P00032640
RR MEDICARE PIN
—
01
—
P00032678
RR MEDICARE PIN
—
01
—
P00032679
RR MEDICARE PIN
—
01
—
P00032681
RR MEDICARE PIN
—
01
—
P00032756
RR MEDICARE PIN
—
01
—
P00032969
RR MEDICARE PIN
—
01
—
P00033122
RR MEDICARE PIN
—
01
—
P00257531
RR MEDICARE PIN
—
Enumeration date
09/12/2005
Last updated
01/13/2021
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