Healthcare Provider Details

I. General information

NPI: 1174789366
Provider Name (Legal Business Name): SUMAN NARASIMHAMURTHY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 05/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

697 PRO-MED LN
CARMEL IN
46032-5323
US

IV. Provider business mailing address

9615 E 148TH ST SUITE 1
NOBLESVILLE IN
46060-4360
US

V. Phone/Fax

Practice location:
  • Phone: 317-574-0055
  • Fax: 317-674-0059
Mailing address:
  • Phone: 317-587-0500
  • Fax: 317-674-0059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number01066558A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: