Individual
LAURA S PRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1002 WISHARD BLVD DEPT OF, INDIANAPOLIS, IN 46202-2872
(317) 944-2801
Mailing address
250 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46219-4959
(317) 962-3834
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01053738
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068010598
MEDICARE PTAN
IN
05
—
200342430
—
IN
Enumeration date
06/06/2006
Last updated
12/28/2020
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