MEDICARE: DR. MARIE E BIERMAN DMD

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
1	1223G0001X	General Practice Dentistry	12014132A	IN

General Provider Information

NPI Number	:	1558045237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIE E BIERMAN DMD

Provider Business Mailing Address
First Line	:	2955 N HIGH SCHOOL RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46224-2915
Country	:	US
Telephone Number	:	317-293-4020
Fax Number	:

Provider Business Practice Location Address
First Line	:	2955 N HIGH SCHOOL RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46224-2915
Country	:	US
Telephone Number	:	317-293-4020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2023
Last Update Date	:	06/13/2023

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