Individual
KATHARINE PORTER O'NEILL I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10122 E 10TH ST STE 100, INDIANAPOLIS, IN 46229-2697
(317) 355-5717
Mailing address
10122 E 10TH ST STE 100, INDIANAPOLIS, IN 46229-2697
(317) 355-5717
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
11023773A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300092271
—
IN
Enumeration date
04/03/2024
Last updated
07/02/2024
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