Individual
ETHAN L FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1801 N SENATE BLVD SUITE 220, INDIANAPOLIS, IN 46202
(317) 962-3700
(317) 962-2893
Mailing address
1801 N SENATE BLVD STE 220, INDIANAPOLIS, IN 46202-1260
(317) 962-3700
(317) 962-2893
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01090971A
IN
208800000X
Urology Physician
35.142317
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102510313
ANTHEM PTAN
IN
05
—
300078672
—
IN
Enumeration date
05/08/2016
Last updated
03/07/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us