Healthcare Provider Details

I. General information

NPI: 1568455491
Provider Name (Legal Business Name): CYNTHIA KAY SEFFERNICK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13914 SOUTHEASTERN PKWY SUITE 314
FISHERS IN
46037-7127
US

IV. Provider business mailing address

8111 TOWNSHIP LINE RD
INDIANAPOLIS IN
46260-2479
US

V. Phone/Fax

Practice location:
  • Phone: 317-872-1415
  • Fax: 317-773-5945
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01066077A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: