Individual
SRIDEVI A VEDANTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10318 COPPER RIDGE DR, FISHERS, IN 46040-1465
(765) 965-6566
Mailing address
10318 COPPER RIDGE DR, FISHERS, IN 46040-1465
(765) 965-6566
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01047370A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000683524
ANTHEM
IN
05
—
200138750
—
IN
Enumeration date
12/02/2005
Last updated
07/28/2021
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