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Individual

KARA BETH KOWALCZYK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
705 RILEY HOSPITAL DR RM 5867, INDIANAPOLIS, IN 46202-5109
(317) 944-4034
Mailing address
705 RILEY HOSPITAL DR RM 5867, INDIANAPOLIS, IN 46202-5109

Taxonomy

Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
01078801A
IN
208000000X
Pediatrics Physician
Primary
01078801A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11017829A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001103550
ANTHEM PTAN
IN
01
000001360999
ANTHEM PTAN
IN
05
300008659
IN
Enumeration date
06/12/2014
Last updated
03/13/2025
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