Provider Demographics
NPI:1659974210
Name:WEBSTER, SAMANTHA DUDMAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:DUDMAN
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-3709
Mailing Address - Country:US
Mailing Address - Phone:317-488-6000
Mailing Address - Fax:
Practice Address - Street 1:220 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-3709
Practice Address - Country:US
Practice Address - Phone:317-488-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26026602A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist