Provider Demographics
NPI:1710069323
Name:HELSEL, SUSAN LEEDY (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:LEEDY
Last Name:HELSEL
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 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11911 N MERIDIAN ST
Practice Address - Street 2:SUITE 120
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-6904
Practice Address - Country:US
Practice Address - Phone:317-621-6818
Practice Address - Fax:317-621-4472
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1046507207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN080148973OtherRAILROAD MEDICARE
INP01456883OtherRR MEDICARE
IN200205850Medicaid
IN0000001072OtherANTHEM LEGACY
IN823720OOOOMedicare PIN
IN0000001072OtherANTHEM LEGACY
IN148310GMedicare PIN
ING83700Medicare UPIN