Individual
PAMELA KULAGA O'DEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
355 W 16TH ST, INDIANAPOLIS, IN 46202-2207
(317) 948-5450
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
01087327A
IN
2084N0400X
Neurology Physician
Primary
01087327A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851755656
ANTHEM PTAN
IN
01
—
262210071
MEDICARE PTAN
IN
05
—
300064927
—
IN
01
—
Q00605924
RAILROAD PTAN
IN
Enumeration date
04/07/2016
Last updated
03/16/2025
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