Individual
DR. SOM DUTT TYAGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 W VOTAW ST, PORTLAND, IN 47371-1322
(260) 726-7131
Mailing address
250 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46219-4959
(317) 963-3137
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01072112A
IN
207Q00000X
Family Medicine Physician
01072112A
IN
207Q00000X
Family Medicine Physician
4301092355
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01072112A
LICENSE
IN
Enumeration date
08/12/2008
Last updated
03/10/2022
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