Provider Demographics
NPI:1316072978
Name:SIWY, BARBARA KATHERINE (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:KATHERINE
Last Name:SIWY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 W CARMEL DR
Mailing Address - Street 2:SUITE 113
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5877
Mailing Address - Country:US
Mailing Address - Phone:317-876-7777
Mailing Address - Fax:317-876-1922
Practice Address - Street 1:755 W CARMEL DR
Practice Address - Street 2:SUITE 113
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5877
Practice Address - Country:US
Practice Address - Phone:317-876-7777
Practice Address - Fax:317-876-1922
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01030432174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
279290Medicare ID - Type Unspecified
INE47552Medicare UPIN