Individual
AUDREY WAGAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8326 NAAB RD, INDIANAPOLIS, IN 46260-1920
(317) 871-0000
(317) 871-0010
Mailing address
8326 NAAB RD, INDIANAPOLIS, IN 46260-1920
(317) 871-0011
(317) 870-4552
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
IN
Other
Enumeration date
05/17/2015
Last updated
09/10/2021
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