Individual
MADISON R COMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1801 N SENATE BLVD STE 535, INDIANAPOLIS, IN 46202-1204
(317) 944-9400
(317) 963-3289
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
71013262A
IN
363LF0000X
Family Nurse Practitioner
Primary
71013262A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102830244
ANTHEM PTAN
IN
01
—
264430G81
MEDICARE PTAN
IN
05
—
300071207
—
IN
01
—
Q00701205
RAILROAD PTAN
IN
Enumeration date
11/04/2022
Last updated
07/08/2024
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