MEDICARE: DR. LAURA M TORMOEHLEN MD

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	207PT0002X	Medical Toxicology (Emergency Medicine) Physician	01066597A	IN
2	2084N0400X	Neurology Physician	11012550A	IN
3	2084N0400X	Neurology Physician	01066597A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740496389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA M TORMOEHLEN MD

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	355 W 16TH ST
Second Line	:	STE 3200
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-2280
Country	:	US
Telephone Number	:	317-948-5450
Fax Number	:	317-962-2141

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

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	03/14/2025

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