Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 01040623A | IN |
NPI | 1013051283 |
---|---|
Provider Name | Dr. Elizabeth Ann Wehlage |
First Address | Indianapolis, IN 46240-2825 |
Second Address | Indianapolis, IN 46260-2479 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2007 |
Last Update Date | 08/07/2007 |