Individual
MATTHEW PELSON PARTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 RILEY HOSPITAL DR STE 2240, INDIANAPOLIS, IN 46202-5109
(317) 944-8620
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
01085840A
IN
207YP0228X
Pediatric Otolaryngology Physician
Primary
01085840A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001570407
ANTHEM PTAN
IN
05
—
300052786
—
IN
Enumeration date
03/26/2015
Last updated
04/11/2025
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