Provider Demographics
NPI:1922059039
Name:BEALL, ABBY E (MD, FACOG)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:E
Last Name:BEALL
Suffix:
Gender:F
Credentials:MD, FACOG
Other - Prefix:
Other - First Name:
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Other - Last Name:
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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:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8012 E 10TH STREET
Practice Address - Street 2:SUITE A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-5211
Practice Address - Country:US
Practice Address - Phone:317-355-6020
Practice Address - Fax:317-355-6028
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01056700A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000491866OtherANTHEM
IN200415390Medicaid
IN200415390Medicaid
IN000000491866OtherANTHEM