Individual
MARTHA L GREENWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1633 N CAPITOL AVE, SUITE 300, INDIANAPOLIS, IN 46202-1261
(317) 962-3724
(317) 962-5039
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71001504A
IN
363LF0000X
Family Nurse Practitioner
Primary
71001504A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
176390K
MEDICARE PTAN
IN
05
—
200863960
—
IN
Enumeration date
05/31/2007
Last updated
10/24/2023
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