Provider Demographics
NPI:1760459713
Name:KINDIG, SUSAN K (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:K
Last Name:KINDIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8780 PURDUE RD
Mailing Address - Street 2:STE 7
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6129
Mailing Address - Country:US
Mailing Address - Phone:317-471-8701
Mailing Address - Fax:317-471-8702
Practice Address - Street 1:8780 PURDUE RD
Practice Address - Street 2:STE 7
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-6129
Practice Address - Country:US
Practice Address - Phone:317-471-8701
Practice Address - Fax:317-471-8702
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01043649A207V00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
160039345OtherRAILROAD
160039345OtherRAILROAD
G04972Medicare UPIN