Individual
TARA K LAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
8890 E 116TH ST, SUITE 300, FISHERS, IN 46038-2856
(317) 621-1500
(317) 621-1509
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02004582A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201171390
—
IN
01
—
P01723966
RR MEDICARE
IN
Enumeration date
05/20/2013
Last updated
11/27/2023
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