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Individual

SHERWIN G IBARRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1030 S SCATTERFIELD RD, ANDERSON, IN 46012-4235
(765) 644-5025
(765) 643-4534
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01057952A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200456740
IN
01
P01027009
RR MEDICARE PTAN
IN
01
P01456890
MEDICARE RR
IN
Enumeration date
06/13/2006
Last updated
04/14/2017
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