Individual
ANGELA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6620 PARKDALE PL, INDIANAPOLIS, IN 46254-5620
(317) 415-7373
Mailing address
10330 N MERIDIAN ST #300, INDIANAPOLIS, IN 46209-1024
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01035146
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100345280A
—
IN
Enumeration date
08/01/2006
Last updated
10/06/2017
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