Individual
SMITHA MARRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1050 WISHARD BLVD, SUITE RG 4100, INDIANAPOLIS, IN 46202-2872
(317) 630-6477
Mailing address
1050 WISHARD BLVD, SUITE RG 4100, INDIANAPOLIS, IN 46202-2872
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01071666A
IN
207RG0100X
Gastroenterology Physician
01071666A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001062468
ANTHEM PTAN
IN
01
—
000001297575
ANTHEM PTAN
IN
05
—
201095690
—
IN
Enumeration date
04/19/2009
Last updated
03/14/2025
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