Knoderer, Holly M

Knoderer, Holly M is an individual health care provider with primary practice located at 705 Riley Hospital Drive Roc 4340, Indianapolis IN 46202-5109. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as her primary health care specialty. Knoderer, Holly M can be contacted via phone (317) 944-5611.

Contact Information

Primary practice address
705 Riley Hospital Drive Roc 4340 Indianapolis IN 46202-5109
Fax: (317) 944-3107
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology 2080P0207X 01063505 Indiana

Profile Details

NPI number 1053530006
LBN Legal business name Knoderer, Holly M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2007
Last updated Feb 18th, 2011 - about 13 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053530006 NPPES
Indiana MEDICAID 200862280

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