Individual
METHEE SRIVATANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8202 CLEARVISTA PARKWAY, SUITE 8, INDIANAPOLIS, IN 46256-1456
(317) 621-1510
(317) 621-1511
Mailing address
6626 E 75TH ST, 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
02003353A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000576528
ANTHEM
IN
01
—
000000657224
ANTHEM
IN
05
—
200910190
—
IN
Enumeration date
05/08/2008
Last updated
11/27/2023
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