Individual
TIMOTHY A MASTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
535 BARNHILL DR, STE 420, INDIANAPOLIS, IN 46202-5112
(317) 278-7560
(317) 274-0174
Mailing address
535 BARNHILL DR, STE 420, INDIANAPOLIS, IN 46202-5112
(317) 278-7560
(317) 274-0174
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01065620A
IN
208800000X
Urology Physician
238907
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000596792
ANTHEM PTAN
IN
01
—
000001040003
ANTHEM PTAN
IN
05
—
200932190
—
IN
Enumeration date
06/02/2008
Last updated
03/14/2025
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