Individual
SUPARNA CHANDRA CLASEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, 9 GATES, CARDIOVASCULAR BUILIDNG, PHILADELPHIA, PA 19104-4238
(267) 324-7534
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01082382A
IN
207R00000X
Internal Medicine Physician
55239
MN
207RC0000X
Cardiovascular Disease Physician
Primary
01082382A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001298801
ANTHEM PTAN
IN
01
—
000001298808
ANTHEM PTAN
IN
01
—
000001300687
ANTHEM PTAN
IN
05
—
300028872
—
IN
Enumeration date
06/13/2011
Last updated
07/25/2025
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