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Individual

DR. TRACY DALLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
8111 S EMERSON AVE, INDIANAPOLIS, IN 46237-8601
(317) 870-6736
(317) 870-0499
Mailing address
PO BOX 6069, DEPT 107, INDIANAPOLIS, IN 46206-6069
(317) 870-6736
(317) 870-0499

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01051055
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200378740
IN
Enumeration date
07/27/2006
Last updated
05/30/2013
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