Individual
SOFIA DIANE PATTYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD # AG012, INDIANAPOLIS, IN 46202-1239
(317) 962-5975
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01088275A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300039322
—
IN
Enumeration date
04/16/2020
Last updated
02/28/2023
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