Schade Willis, Tina Marie

Schade Willis, Tina Marie is an individual health care provider with primary practice located at 705 Riley Hospital Dr , Indianapolis IN 46202. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is her primary health care specialty. Schade Willis, Tina Marie can be contacted via phone (317) 948-7128.

Contact Information

Primary practice address
705 Riley Hospital Dr Indianapolis IN 46202
Phone: (317) 948-7128
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207LC0200X 01080559A Indiana
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 0400964 North Carolina
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 01080559A Indiana

Profile Details

NPI number 1801809934
LBN Legal business name Schade Willis, Tina Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2006
Last updated Oct 30th, 2018 - about 6 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 1801809934 NPPES
Indiana MEDICAID 300015476

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