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Individual

DR. MARION E COUCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
550 UNIVERSITY BLVD, RM 3170, INDIANAPOLIS, IN 46202-5149
(317) 962-3886
(317) 948-1245
Mailing address
250 N SHADELAND AVE, SUITE 130, INDIANAPOLIS, IN 46219-4959
(317) 963-0860
(919) 843-5515

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01074224A
IN
207Y00000X
Otolaryngology Physician
200300767
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201233850
IN
01
P101641537
RAILROAD MEDICARE
IN
Enumeration date
10/03/2006
Last updated
06/29/2016
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