Individual
AMANDA LEIGH AGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 W MICHIGAN ST, CL 630, INDIANAPOLIS, IN 46202-5209
(317) 278-2689
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01085911A
IN
207RI0200X
Infectious Disease Physician
Primary
01085911A
IN
207RI0200X
Infectious Disease Physician
1598113854
IN
390200000X
Student in an Organized Health Care Education/Training Program
11018685A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001545820
ANTHEM PTAN
IN
05
—
201369430
—
IN
Enumeration date
05/27/2016
Last updated
05/06/2025
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