Individual
SUJAL HEMANT MODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 880-7666
(317) 880-0448
Mailing address
OSU DIVSION OF CARDIOVASCULAR MEDICINE, 473 W 12TH AVE STE 200, COLUMBUS, OH 43210-1252
(614) 292-4967
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01090483A
IN
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
01090483A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
01090483A
IN
207RC0000X
Cardiovascular Disease Physician
MD467708
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102845520
ANTHEM PTAN
IN
05
—
300081931
—
IN
Enumeration date
04/29/2013
Last updated
03/14/2025
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