Ferrer, Modeson-Samuel Banez

Ferrer, Modeson-Samuel Banez is an individual health care provider with primary practice located at 2560 N Shadeland Ave Ste A, Indianapolis IN 46219-1705. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Ferrer, Modeson-Samuel Banez can be contacted via phone (866) 463-7284.

Contact Information

Primary practice address
2560 N Shadeland Ave Ste A Indianapolis IN 46219-1705
Phone: (866) 463-7284
Fax: (610) 271-4245
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 207ZP0102X Wisconsin
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 01070026A Indiana

Profile Details

NPI number 1386711711
LBN Legal business name Ferrer, Modeson-Samuel Banez
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2006
Last updated Oct 25th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386711711 NPPES
Indiana MEDICAID 201046610

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