Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ML60292595 | WA |
Y | 2080P0210X | Pediatric Nephrologist | 01082551A | IN |
NPI | 1083989172 |
---|---|
Provider Name | Michelle Casey Starr |
First Address | Indianapolis, IN 46206-1026 |
Second Address | Indianapolis, IN 46202-5119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2012 |
Last Update Date | 18/11/2020 |