Healthcare Provider Details

I. General information

NPI: 1679606792
Provider Name (Legal Business Name): KAREN E FISCHER-WEDDELL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 08/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 E 86TH ST STE 1
INDIANAPOLIS IN
46240-6860
US

IV. Provider business mailing address

2001 DAKOTA DR
NOBLESVILLE IN
46062-9075
US

V. Phone/Fax

Practice location:
  • Phone: 317-575-2888
  • Fax: 317-575-2898
Mailing address:
  • Phone: 317-776-0333
  • Fax: 317-776-3003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12008693
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: