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Individual

SUSAN M. GASTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 944-4842
Mailing address
PO BOX 719094, CHICAGO, IL 60677-9318
(317) 777-6435
(317) 777-6644

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01082429A
IN
208000000X
Pediatrics Physician
35122378
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300027407
IN
Enumeration date
11/07/2006
Last updated
02/14/2026
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