Individual
STEVEN M INDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 258-6504
Mailing address
700 S PARK ST, MADISON, WI 53715-1830
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
56747-21
WI
2083A0100X
Aerospace Medicine Physician
TL945
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Enumeration date
10/07/2005
Last updated
11/29/2016
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