Individual
TARAH JEAN BALLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1030 W MICHIGAN ST, INDIANAPOLIS, IN 46202-5112
(317) 948-6260
(317) 278-2262
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01076042A
IN
207RH0003X
Hematology & Oncology Physician
Primary
01076042A
IN
207RX0202X
Medical Oncology Physician
01076042A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001081894
ANTHEM PTAN
IN
05
—
201305570
—
IN
Enumeration date
05/22/2012
Last updated
02/26/2025
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