Individual
SUJATA PANTHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1115 RONALD REAGAN PKWY, AVON, IN 46123-6910
(317) 843-0000
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01087705A
IN
207R00000X
Internal Medicine Physician
1407222714
IN
207R00000X
Internal Medicine Physician
25670
MS
207R00000X
Internal Medicine Physician
57465
TN
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
01087705A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102690082
ANTHEM PTAN
IN
01
—
1407222714
ANTHEM PTAN
IN
05
—
300065723
—
IN
Enumeration date
08/20/2015
Last updated
03/15/2025
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