Individual
GARRETT WADE OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1633 N CAPITOL AVE STE 640, INDIANAPOLIS, IN 46202-1281
(317) 962-8881
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01097374A
IN
207P00000X
Emergency Medicine Physician
Primary
01097374A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000075507
ANTHEM PTAN
IN
05
—
300120333
—
IN
Enumeration date
05/25/2021
Last updated
06/08/2026
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