Provider Demographics
NPI:1437972817
Name:SAPAL, NATHAN P (PA-C)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:P
Last Name:SAPAL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8820 S MERIDIAN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-6058
Mailing Address - Country:US
Mailing Address - Phone:317-865-6750
Mailing Address - Fax:317-865-6759
Practice Address - Street 1:8820 S MERIDIAN ST STE 200
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46217-6058
Practice Address - Country:US
Practice Address - Phone:317-865-6750
Practice Address - Fax:317-865-6759
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN10004625A363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant