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Individual

SHRIVIDYA KARTHIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
7120 CLEARVISTA DR, SUITE 2100, INDIANAPOLIS, IN 46256-1621
(317) 621-5676
(317) 621-5678
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01064894A
IN
207R00000X
Internal Medicine Physician
4301080321
MI
208M00000X
Hospitalist Physician
4301080321
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4762921
MI
01
P01212114
RR MEDICARE PTAN
IN
Enumeration date
07/21/2005
Last updated
12/03/2014
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