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Individual

NEAL EDWARD IPEMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 TOWN CENTER RD S, SUITEB, MOORESVILLE, IN 46158-2321
(317) 497-2300
(317) 497-2502
Mailing address
6626 E 75TH ST, 500, INDIANAPOLIS, IN 46250-2805

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01071411A
IN
207V00000X
Obstetrics & Gynecology Physician
036.123815
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000775099
ANTHEM
IN
05
201075840
IN
01
400280
GROUP MEDICARE PTAN
IL
Enumeration date
02/17/2010
Last updated
11/27/2023
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