Organization
INDYDERM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY KELLER MD (OWNER)
(317) 215-0928
Entity
Organization
Contact information
Practice address
521 E COUNTY LINE RD STE E, GREENWOOD, IN 46143-1066
(317) 215-0928
(317) 743-8148
Mailing address
521 E COUNTY LINE RD STE E, GREENWOOD, IN 46143-1066
(317) 215-0928
(317) 743-8148
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
01072313A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08029326
—
IN
Enumeration date
06/14/2016
Last updated
02/19/2024
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