Individual
DR. PENNY ELIZABETH KALLMYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6640 PARKDALE PLACE, SUITE U, INDIANAPOLIS, IN 46254-4698
(317) 291-5190
(317) 291-1510
Mailing address
6640 PARKDALE PLACE, SUITE U, INDIANAPOLIS, IN 46254-4698
(317) 291-5190
(317) 291-1510
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01041481A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000093913
ANTHEM
—
05
—
200010530
—
IN
Enumeration date
10/06/2006
Last updated
12/08/2011
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