Individual
MICAH T MATHAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13100 E 136TH ST STE 2400, FISHERS, IN 46037-9810
(317) 328-6620
Mailing address
13100 E 136TH ST STE 2400, FISHERS, IN 46037-9810
(317) 328-6620
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01089614A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300080213
—
IN
Enumeration date
02/26/2019
Last updated
06/26/2025
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