Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 01028103 | IN |
NPI | 1578656468 |
---|---|
Provider Name | Sharon P Andreoli |
First Address | Indianapolis, IN 46206-1026 |
Second Address | Indianapolis, IN 46202-5109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 26/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000375508 | ANTHEM-DEAC-350593390 (01) | |
100236800 | (05) | IN |
350593390-042 | TRICARE-DEAC-350593390 (01) | |
64879182 | (05) | KY |
B29553 | (02) |