Organization
SERENITY MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYED J KHAN MD (PRESIDENT)
(317) 621-4181
Entity
Organization
Contact information
Practice address
10765 LANTERN RD, STE 102, FISHERS, IN 46038-3597
(317) 621-4181
(317) 621-4182
Mailing address
10765 LANTERN RD, STE 102, FISHERS, IN 46038-3597
(317) 621-4181
(317) 621-4182
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000691245
ANTHEM
IN
01
—
482287
MANAGED HEALTH NETWORK (MHN)
IN
01
—
9657571
AETNA
IN
Enumeration date
11/04/2010
Last updated
09/19/2012
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