Individual
ELIZABETH BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8150 OAKLANDON RD, SUITE 130, INDIANAPOLIS, IN 46236-9525
(317) 823-4435
Mailing address
8150 OAKLANDON RD, SUITE 130, INDIANAPOLIS, IN 46236-9525
(317) 823-4435
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01051050A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000359024
ANTHEM
IN
05
—
200334520
—
IN
Enumeration date
07/27/2006
Last updated
10/30/2007
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