Healthcare Provider Details

I. General information

NPI: 1497732770
Provider Name (Legal Business Name): MARY PAULINE TRAINOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY PAULINE (POLLY) GOUGH M.D.

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 WESTFIELD RD 100
NOBLESVILLE IN
46060-1443
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-773-5876
  • Fax: 317-776-0363
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01034574
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01034574A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: