Provider Demographics
NPI:1366603904
Name:PIERCE, SARA MICHELLE (MD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MICHELLE
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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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 1:7120 CLEARVISTA DRIVE
Practice Address - Street 2:SUITE 4000
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1774
Practice Address - Country:US
Practice Address - Phone:317-621-7444
Practice Address - Fax:317-621-3150
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01068362A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP01157066OtherMEDICARE RAILROAD
IN201022020Medicaid
IN000000773347OtherANTHEM
IN000000773347OtherANTHEM