Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 01027896A | IN |
NPI | 1437139144 |
---|---|
Provider Name | Dr. Karen W West |
First Address | Indianapolis, IN 46250-2805 |
Second Address | Indianapolis, IN 46256 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 30/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100143770 | (05) | IN |
E03648 | (02) | |
P01777146 | RR MEDICARE (01) | IN |