Provider Demographics
NPI:1255424594
Name:MENON, PRIYA P (MD)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:P
Last Name:MENON
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1100 SOUTHFIELD DR
Mailing Address - Street 2:SUITE 1370
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-4498
Mailing Address - Country:US
Mailing Address - Phone:317-837-5571
Mailing Address - Fax:317-837-5580
Practice Address - Street 1:100 HOSPITAL LN
Practice Address - Street 2:SUITE 205
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1989
Practice Address - Country:US
Practice Address - Phone:317-745-7445
Practice Address - Fax:317-745-7449
Is Sole Proprietor?:No
Enumeration Date:2006-10-01
Last Update Date:2021-03-08
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Provider Licenses
StateLicense IDTaxonomies
IN01062716A207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200904550Medicaid
IN200904550Medicaid