Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 006171 | GA |
N | 208600000X | Surgeon | 006171 | GA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 11020514A | IN |
NPI | 1023457934 |
---|---|
Provider Name | Dr. Erika Simmerman Mabes |
First Address | Indianapolis, IN 46202 |
Second Address | Indianapolis, IN 46202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2013 |
Last Update Date | 31/05/2019 |