Individual
TRICIA JACLYN KREUTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13000 E 136TH ST, FISHERS, IN 46037-9478
(317) 880-3900
(317) 880-0545
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01062615A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000573775
BCBS
OH
05
—
2901775
—
OH
Enumeration date
07/02/2007
Last updated
10/06/2022
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