Individual
AJANTA GOSWAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3620 W WHITE RIVER BLVD, MUNCIE, IN 47304-4286
(765) 288-1928
(765) 288-2032
Mailing address
240 N TILLOTSON AVE, MUNCIE, IN 47304-3988
(765) 288-1928
(765) 741-0335
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
01050577
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200237850
—
IN
Enumeration date
02/15/2006
Last updated
09/08/2016
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