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Individual

DIANNA M KEISERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
550 UNIVERSITY BLVD, RADIOLOGY DEPARTMENT, INDIANAPOLIS, IN 46202-5149
(317) 278-9729
Mailing address
714 N SENATE AVE, STE EF100, INDIANAPOLIS, IN 46202-3763
(317) 715-6402
(317) 715-6415

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001064
IN
363A00000X
Physician Assistant
1433
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41963600
WI
Enumeration date
04/24/2006
Last updated
05/20/2009
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