Andhole, Indira P
Andhole, Indira P is an individual health care provider with primary practice located at 1881 Chicago St , Depere WI 54115. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Andhole, Indira P can be contacted via phone (920) 403-8000.Contact Information
Primary practice address
1881 Chicago St
Depere WI 54115
Phone: (920) 403-8000
Fax: (920) 403-8204
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 40289 | Wisconsin |
Profile Details
| NPI number | 1184632747 |
|---|---|
| LBN Legal business name | Andhole, Indira P |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2006 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184632747 | NPPES |
| Wisconsin | MEDICAID | 32593400 |
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