Individual
THOMAS PETRIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11911 N. MERIDIAN, SUITE 100, INDIANAPOLIS, IN 46032
(317) 621-6800
Mailing address
11911 N. MERIDIAN, SUITE 100, INDIANAPOLIS, IN 46032
(317) 621-6800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01024966A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000313296
ANTHEM
IN
01
—
P00092387
RR MEDICARE
IN
Enumeration date
07/25/2006
Last updated
11/01/2007
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