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NPI Code Detail

MEDICARE: AMY ELIZABETH GOLDIE RAY PA

MEDICARE: AMY ELIZABETH GOLDIE RAY PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant10000914IN
2363AM0700XMedical Physician Assistant10000914AIN

General Provider Information

NPI Number : 1326137498
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY ELIZABETH GOLDIE RAY PA
Provider Business Mailing Address
First Line : 10590 N MERIDIAN ST
Second Line :
City : CARMEL
State : IN
Zip : 46290-1028
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10590 N MERIDIAN ST
Second Line :
City : CARMEL
State : IN
Zip : 46290-1028
Country : US
Telephone Number : 317-338-6666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 07/21/2023

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