Provider Demographics
NPI:1427218098
Name:DELIMA, SARAH ISIS R (MD)
Entity type:Individual
Prefix:
First Name:SARAH ISIS
Middle Name:R
Last Name:DELIMA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11590 N. MERIDIAN ST.
Practice Address - Street 2:STE. 300
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4529
Practice Address - Country:US
Practice Address - Phone:317-948-7450
Practice Address - Fax:317-948-3408
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11014254A208000000X
IN01073495A2084N0402X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000861585OtherANTHEM PTAN
IN201111270Medicaid