Individual
MIROSLAVA KOUZMOVA-MONEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5230 E STOP 11 RD STE 150, INDIANAPOLIS, IN 46237-6399
(317) 865-5904
(317) 865-5321
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01052138A
IN
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
01052138
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000373045
ANTHEM
IN
05
—
200521240
—
IN
05
—
2599577
—
OH
01
—
P00291784
RAILROAD
—
Enumeration date
02/27/2006
Last updated
05/09/2023
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