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Individual

BRIAN TIEN TRAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CAA

Contact information

Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 577-4200
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
75000114A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1102699518
ANTHEM PTAN
IN
Enumeration date
11/02/2022
Last updated
11/25/2024
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