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Individual

SUSAN CHACE LOTTICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
7120 CLEARVISTA DR STE 3200, INDIANAPOLIS, IN 46256-1782
(317) 621-7780
(317) 621-7783
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01037538A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000681404
ANTHEM
IN
01
000000780857
ANTHEM
IN
05
100130980
IN
01
P01170034
RR MEDICARE PTAN
IN
Enumeration date
11/28/2005
Last updated
04/07/2026
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