Provider Demographics
NPI:1376591255
Name:HUMMER, SIMING CHEN (MD)
Entity Type:Individual
Prefix:
First Name:SIMING
Middle Name:CHEN
Last Name:HUMMER
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 1:1111 RONALD REAGAN PKWY STE 1540
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-7085
Mailing Address - Country:US
Mailing Address - Phone:317-217-2211
Mailing Address - Fax:317-217-2559
Practice Address - Street 1:1111 RONALD REAGAN PKWY STE 1540
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7085
Practice Address - Country:US
Practice Address - Phone:317-217-2211
Practice Address - Fax:317-217-2559
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010490032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200278100Medicaid
IN945520SSSMedicare ID - Type Unspecified
INM400064766Medicare PIN
IN200278100Medicaid