Individual
TAYLOR S SIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
720 ESKENAZI AVE # H2G07, INDIANAPOLIS, IN 46202-5187
(317) 880-5386
(317) 880-5385
Mailing address
720 ESKENAZI AVE # H2G07, INDIANAPOLIS, IN 46202-5187
(317) 880-5386
(317) 880-5385
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
75000055A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001425310
ANTHEM PTAN
IN
Enumeration date
02/05/2020
Last updated
12/02/2024
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