Individual
SERENA KORTEPETER BASKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8177 CLEARVISTA PKWY, INDIANAPOLIS, IN 46256-1662
(317) 621-7801
(317) 621-7205
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01067146A
IN
207Q00000X
Family Medicine Physician
12862
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01Y008991NH03
ANTHEM ID - GRANTHAM
NH
01
—
01YP08991NH01
ANTHEM ID - NLHP
NH
05
—
200966820
—
IN
05
—
30205561
—
NH
01
—
4147497
MVP ID
—
01
—
71029982
CIGNA ID
NH
01
—
AA47227
HARVARD PILGRIM ID
—
Enumeration date
09/01/2006
Last updated
11/27/2023
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