Individual
ALISON Q KOSTANDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
355 W 15TH ST, INDIANAPOLIS, IN 46202
(317) 948-7450
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
01088115A
IN
2084N0400X
Neurology Physician
Primary
01088115A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102690175
ANTHEM PTAN
IN
01
—
1730535121
ANTHEM PTAN
IN
05
—
300064368
—
IN
01
—
Q00487532
RAILROAD PTAN
IN
Enumeration date
05/04/2016
Last updated
03/17/2025
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