Provider Demographics
NPI:1417160680
Name:KROBER, MIRIAM TYNDALL (MD)
Entity Type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:TYNDALL
Last Name:KROBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MIRIAM
Other - Middle Name:LEAH
Other - Last Name:TYNDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1111 RONALD REAGAN PKWY STE C1400
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:317-217-7777
Practice Address - Fax:317-217-2775
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA204249207VG0400X
IN01071366A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology