Provider Demographics
NPI:1790873818
Name:HOWARD, NORRISA J (MD)
Entity Type:Individual
Prefix:DR
First Name:NORRISA
Middle Name:J
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NORRISA
Other - Middle Name:N
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11911 N MERIDIAN ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-6904
Mailing Address - Country:US
Mailing Address - Phone:317-571-1151
Mailing Address - Fax:317-571-0116
Practice Address - Street 1:11911 N MERIDIAN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-6904
Practice Address - Country:US
Practice Address - Phone:317-571-1151
Practice Address - Fax:317-571-0116
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052737A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200299640BMedicaid
IN566164OtherANTHEM
IN200299640BMedicaid