Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 01042086 | IN |
NPI | 1073559027 |
---|---|
Provider Name | Mary Pell Abernathy |
First Address | Indianapolis, IN 46250-2890 |
Second Address | Indianapolis, IN 46256 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 18/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100378350 | (05) | IN |
F75193 | (02) |