Provider Demographics
NPI:1346496932
Name:HO, MINDY M (MD)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:M
Last Name:HO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 SOUTHFIELD DR
Mailing Address - Street 2:STE 1370
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-4300
Mailing Address - Country:US
Mailing Address - Phone:317-837-5570
Mailing Address - Fax:317-837-5580
Practice Address - Street 1:112 HOSPITAL LN STE 100
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-2600
Practice Address - Country:US
Practice Address - Phone:317-745-3740
Practice Address - Fax:317-745-3816
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01070443A208600000X
IL036.120666208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201074590Medicaid
INM471400003OtherMEDICARE PROVIDER PTAN