Individual
SARAH RENE WALSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-2500
(317) 962-2515
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003444A
IN
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000125008
ANTHEM PTAN
IN
01
—
264430E36
MEDICARE
IN
05
—
300066187
—
IN
01
—
Q00404992
RAILROAD PTAN
IN
Enumeration date
09/06/2021
Last updated
05/17/2024
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