Provider Demographics
NPI:1063504231
Name:FOREMAN, TONYA (MD)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9106 N MERIDIAN ST
Mailing Address - Street 2:STE 100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1884
Mailing Address - Country:US
Mailing Address - Phone:317-575-9111
Mailing Address - Fax:317-571-4460
Practice Address - Street 1:9106 N MERIDIAN ST
Practice Address - Street 2:STE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1884
Practice Address - Country:US
Practice Address - Phone:317-575-9111
Practice Address - Fax:317-571-4460
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01057904A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ING23544Medicare UPIN
IN116660D6Medicare ID - Type Unspecified