Individual
ANGELA KAYE UNFRIED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
8075 N SHADELAND AVE, SUITE 120, INDIANAPOLIS, IN 46250-2693
(317) 355-7220
(317) 355-9672
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10000709A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201100470
—
IN
01
—
P01261837
MEDICARE RR PTAN
IN
Enumeration date
07/01/2005
Last updated
06/14/2021
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