Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 02005215A | IN |
N | 207Q00000X | Family Doctor | 39872 | SC |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 02005215A | IN |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 39872 | SC |
NPI | 1295171726 |
---|---|
Provider Name | Ms. Veera N Motashaw |
First Address | Indianapolis, IN 46250-2890 |
Second Address | Fishers, IN 46037-4154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2013 |
Last Update Date | 17/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300005242 | (05) | IN |