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Individual

KRISTEN INGRAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1002 N SHELBY ST STE 1004, SALEM, IN 47167
(812) 883-9182
Mailing address
1002 N SHELBY ST STE 1004, SALEM, IN 47167-2307

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01060058A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200275770
IN
Enumeration date
05/16/2006
Last updated
06/30/2022
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