Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 01079817 | IN |
NPI | 1235524182 |
---|---|
Provider Name | Elizabeth Spiwak |
First Address | Indianapolis, IN 46260-2052 |
Second Address | Indianapolis, IN 46260-2052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2015 |
Last Update Date | 29/06/2021 |