Individual
SIMRAN K JUTLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 948-7208
(317) 944-7245
Mailing address
PO BOX 719094, CHICAGO, IL 60677-9318
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
01085957A
IN
208000000X
Pediatrics Physician
01085957A
IN
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
01085957A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103673141
ANTHEM PTAN
IN
05
—
300051677
—
IN
Enumeration date
03/20/2018
Last updated
02/06/2026
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