Individual
JIE XIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 274-0275
(317) 274-0256
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01083484A
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
01083484A
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
036.156337
IL
390200000X
Student in an Organized Health Care Education/Training Program
11020054A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102233913
ANTHEM PTAN
IN
05
—
300062008
—
IN
Enumeration date
06/04/2015
Last updated
11/21/2024
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