Individual
MICAYAH OVERDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-NC
Contact information
Practice address
7165 CLEARVISTA WAY, INDIANAPOLIS, IN 46256-4621
(317) 621-6262
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003159A
IN
Other
Enumeration date
07/15/2021
Last updated
07/26/2021
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