Individual
SEAN PFAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
714 N SENATE AVE STE 100, INDIANAPOLIS, IN 46202-3297
(317) 948-6328
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01078689A
IN
2085R0204X
Vascular & Interventional Radiology Physician
Primary
01078689A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300003418
—
IN
01
—
959090062
MEDICARE PTAN
IN
01
—
P02565277
RAILROAD PTAN
IN
Enumeration date
07/09/2010
Last updated
12/28/2023
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