Individual
DR. LAURA WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5515 W 38TH ST, INDIANAPOLIS, IN 46254-2919
(317) 880-3838
Mailing address
PO BOX 637764, CINCINNATI, OH 45263-7764
(317) 880-3939
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01070071A
IN
390200000X
Student in an Organized Health Care Education/Training Program
4301083454
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000743091
ANTHEM PROVIDER NUMBER
IN
05
—
201045100
—
IN
Enumeration date
03/14/2007
Last updated
10/02/2025
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