Individual
CAROL K FOSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
70 E 91ST ST STE 204, INDIANAPOLIS, IN 46240-1564
(317) 872-4213
(317) 872-6388
Mailing address
70 E 91ST ST STE 204, INDIANAPOLIS, IN 46240-1564
(317) 872-4213
(317) 872-6388
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
1037197
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100132220
—
IN
Enumeration date
11/02/2005
Last updated
04/03/2019
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