Provider Demographics
NPI:1225301336
Name:BARBARA K SIWY MD PC
Entity Type:Organization
Organization Name:BARBARA K SIWY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SIWY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-876-7777
Mailing Address - Street 1:755 W CARMEL DR STE 113
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5875
Mailing Address - Country:US
Mailing Address - Phone:317-876-7777
Mailing Address - Fax:317-876-1922
Practice Address - Street 1:755 W CARMEL DR STE 113
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5875
Practice Address - Country:US
Practice Address - Phone:317-876-7777
Practice Address - Fax:317-876-1922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01030432174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN279290Medicare UPIN