Provider Demographics
NPI:1689657553
Name:SZEWCZYK, EMILY KAE (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:KAE
Last Name:SZEWCZYK
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 1:12174 N MERIDIAN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-4578
Mailing Address - Country:US
Mailing Address - Phone:317-688-9000
Mailing Address - Fax:317-680-9900
Practice Address - Street 1:12174 N MERIDIAN ST STE 300
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4578
Practice Address - Country:US
Practice Address - Phone:317-688-9000
Practice Address - Fax:317-680-9900
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01056611A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200473850Medicaid
I11152Medicare UPIN
IN220620KKMedicare PIN