Individual
DR. KOSHY OOMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
747 E COUNTY LINE RD STE B, GREENWOOD, IN 46143-1082
(317) 789-9600
(317) 789-0600
Mailing address
747 E COUNTY LINE RD STE B, GREENWOOD, IN 46143-1082
(317) 789-9600
(317) 789-0600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01058502A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000333114
COMMERCIAL
IN
01
—
P00117066
RR MEDICARE
IN
01
—
P01045880
RAILROAD MEDICARE
IN
Enumeration date
10/12/2006
Last updated
03/31/2021
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