Individual
DR. SAMANTHA LEIGH TARRAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-0585
(317) 962-2082
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01089195A
IN
208600000X
Surgery Physician
4301087985
MI
2086S0102X
Surgical Critical Care Physician
Primary
01089195A
IN
2086S0102X
Surgical Critical Care Physician
4301087985
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
233690178
MEDICARE PTAN
IN
Enumeration date
05/22/2007
Last updated
05/03/2023
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