Individual
MARIA L SROUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5165 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 448-8000
(765) 448-7631
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01084037A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
01084037A
IN
207RP1001X
Pulmonary Disease Physician
01084037A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
267030307
MEDICARE PTAN
IN
05
—
300039733
—
IN
01
—
815500574
MEDICARE PTAN
IN
Enumeration date
04/20/2016
Last updated
03/12/2025
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