Individual
DR. AMANDA MICHELE O'MARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8111 S EMERSON AVE, INDIANAPOLIS, IN 46237-8601
(317) 870-6736
(317) 870-0499
Mailing address
PO BOX 6069 DEPT 107, INDIANAPOLIS, IN 46206-6069
(317) 870-6736
(317) 870-0499
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01071034
IN
207R00000X
Internal Medicine Physician
11014408A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000772905
ANTHEM
IN
05
—
201085250
—
IN
01
—
M400074668
MEDICARE
IN
01
—
P01100799
RAILROAD MEDICARE
IN
Enumeration date
06/18/2008
Last updated
05/28/2013
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