Individual
DR. ELISABETH P PROSSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 BROAD RIPPLE AVE, INDIANAPOLIS, IN 46220-2093
(317) 338-4200
Mailing address
10330 N MERIDIAN ST # 300, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01038709A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100121660
—
IN
Enumeration date
11/23/2005
Last updated
12/13/2016
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