Individual
LEV VAISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
355 W 16TH ST STE 3200, INDIANAPOLIS, IN 46202-2280
(317) 948-5450
(317) 968-1256
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
(317) 963-9328
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
01087736A
IN
2084N0400X
Neurology Physician
01087736A
IN
2084N0400X
Neurology Physician
Primary
35144334
OH
2084N0600X
Clinical Neurophysiology Physician
01087736A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102682930
ANTHEM PTAN
IN
05
—
300062649
—
IN
Enumeration date
05/18/2016
Last updated
03/14/2025
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