Individual
JODY P GHOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
720 S 6TH ST, MONTICELLO, IN 47960-8182
(574) 583-1785
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01061107A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000490201
ANTHEM
IN
05
—
200433670
—
IN
05
—
20433670
—
IN
01
—
264430E17
MEDICARE
IN
Enumeration date
07/28/2006
Last updated
02/16/2023
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