Healthcare Provider Details

I. General information

NPI: 1548183429
Provider Name (Legal Business Name): VIRGINIA BYRAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12065 OLD MERIDIAN ST
CARMEL IN
46032-8773
US

IV. Provider business mailing address

12065 OLD MERIDIAN ST
CARMEL IN
46032-8773
US

V. Phone/Fax

Practice location:
  • Phone: 317-819-4545
  • Fax: 317-705-2700
Mailing address:
  • Phone: 317-819-4545
  • Fax: 317-705-2700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number23002971A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: