Individual
LAURA K CORBITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7950 N SHADELAND AVE, STE 350, INDIANAPOLIS, IN 46250-2691
(317) 621-6900
(317) 621-4460
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001784A
IN
363AM0700X
Medical Physician Assistant
0110004253
VA
363AM0700X
Medical Physician Assistant
10001784A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001784A
INDIANA
IN
01
—
P01512403
MEDICARE RR
IN
Enumeration date
08/19/2013
Last updated
01/06/2022
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