Provider Demographics
NPI:1427218098
Name:DELIMA, SARAH ISIS R (MD)
Entity Type:Individual
Prefix:
First Name:SARAH ISIS
Middle Name:R
Last Name:DELIMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:SUITE 130 - PROVIDER ENROLLMENT
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 1:11590 N. MERIDIAN ST.
Practice Address - Street 2:STE. 300
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4529
Practice Address - Country:US
Practice Address - Phone:317-948-7450
Practice Address - Fax:317-948-3408
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN11014254A208000000X
IN01073495A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201111270Medicaid
IN262210005Medicare PIN