Individual
MRS. JULIE MICHELLE VANDERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1801 N SENATE BLVD, SUITE 4000, INDIANAPOLIS, IN 46202-1228
(317) 962-2500
(317) 962-2515
Mailing address
250 N SHADELAND AVE, STE 130 PROVDIER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10001596A
IN
Other
Enumeration date
10/24/2013
Last updated
12/29/2020
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