Provider Demographics
NPI:1104829746
Name:PRITZ, MICHAEL B (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:B
Last Name:PRITZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8333 NAAB RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5924
Mailing Address - Country:US
Mailing Address - Phone:317-396-1300
Mailing Address - Fax:317-396-1346
Practice Address - Street 1:1801 N SENATE BLVD
Practice Address - Street 2:SUITE 535
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1291
Practice Address - Country:US
Practice Address - Phone:317-396-1300
Practice Address - Fax:317-396-1346
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2011-02-17
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Provider Licenses
StateLicense IDTaxonomies
IN01041412207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100322860Medicaid
IN000000638987OtherANTHEM BLUE CROSS AND BLUE SHIELD
IN100322860Medicaid
IN061570RRRRMedicare PIN