Individual
MATTHEW M AMAYUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
355 W 16TH ST STE 5100, INDIANAPOLIS, IN 46202-2274
(317) 963-1300
(317) 222-2012
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71009325A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001324791
ANTHEM PTAN
IN
05
—
300031774
—
IN
Enumeration date
09/07/2019
Last updated
05/08/2025
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