Individual
TAMMY N DURHAM-BORING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
9894 E 121ST ST, FISHERS, IN 46037
(317) 621-6060
(317) 355-6965
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
02002205A
IN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
02002205A
IN
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
02002205A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000714181
ANTHEM
—
05
—
200266500
—
IN
01
—
P01424312
RR MEDICARE
IN
Enumeration date
01/19/2006
Last updated
09/12/2023
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