Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 01040150A | IN |
Y | 207YP0228X | Pediatric Otolaryngology | 01040150A | IN |
NPI | 1174572184 |
---|---|
Provider Name | Ronda Alazan Hamaker |
First Address | Indianapolis, IN 46260-1316 |
Second Address | Indianapolis, IN 46260-2053 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 15/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200080650 | (05) | IN |
G22914 | (02) |