Provider Demographics
NPI:1497745566
Name:SMIDT, VERONICA J (MD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:J
Last Name:SMIDT
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 1:8360 S EMERSON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8745
Mailing Address - Country:US
Mailing Address - Phone:317-859-2535
Mailing Address - Fax:317-859-2540
Practice Address - Street 1:8360 S EMERSON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8745
Practice Address - Country:US
Practice Address - Phone:317-859-2535
Practice Address - Fax:317-859-2540
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01048963A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200390800Medicaid
IN677690IMedicare PIN
IN200390800Medicaid
INP00175876Medicare PIN