Individual
MONICA E MAZDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1400 N RITTER AVE STE 220, INDIANAPOLIS, IN 46219-3046
(317) 716-5600
(317) 716-5618
Mailing address
6983 HILLSDALE CT, INDIANAPOLIS, IN 46250-2054
(317) 849-8350
(317) 576-6311
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01074199A
IN
2084N0600X
Clinical Neurophysiology Physician
01074199A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201109640
—
IN
Enumeration date
05/28/2009
Last updated
03/23/2021
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