Individual
MAUREEN E SAMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13121 OLIO ROAD, SUITE 300, FISHERS, IN 46037-7240
(317) 621-1300
(317) 621-1310
Mailing address
6626 E. 75TH STREET, SUITE 500, INDIANAPOLIS, IN 46250-2790
(317) 621-1303
(317) 621-1310
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01067225A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000639909
ANTHEM
IN
05
—
200958820
—
IN
01
—
9409431
AETNA
IN
01
—
P01061524
MEDICARE RR
IN
Enumeration date
02/25/2008
Last updated
11/27/2023
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