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Individual

JAMES T FESENMEIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1115 RONALD REAGAN PKWY, STE 141, AVON, IN 46123-6913
(317) 948-5450
(317) 217-2585
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01040145A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000333460
ANTHEM
IN
05
100334160
IN
Enumeration date
07/27/2006
Last updated
03/07/2025
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