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Individual

HEIDI M BAGWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3000 S STATE ROAD 135 STE 330, GREENWOOD, IN 46143-9825
(317) 497-2400
(317) 497-2515
Mailing address
1711 S STATE ROAD 135, SUITE C, GREENWOOD, IN 46143-6480
(317) 881-7400
(317) 881-7477

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01060982A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200527050
IN
Enumeration date
08/13/2006
Last updated
04/24/2025
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