Individual
SHRISTI SHRESTHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8177 CLEARVISTA PKWY, INDIANAPOLIS, IN 46256-1662
(317) 621-7801
(317) 621-7205
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01067748A
IN
207Q00000X
Family Medicine Physician
LL 30048
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01014120
RR MEDICARE PTAN
IN
Enumeration date
08/06/2007
Last updated
07/21/2015
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