Basic Information
| Provider Information | |||||||||
| NPI: | 1881788115 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FARRIA | ||||||||
| FirstName: | DIONE | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1481 W 10TH ST | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462022803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3179882561 | ||||||||
| FaxNumber: | 3147474189 | ||||||||
| Practice Location | |||||||||
| Address1: | 1481 W 10TH ST | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462022803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3179882561 | ||||||||
| FaxNumber: | 3149885409 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 08/26/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 1999137420 | MO | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2083P0901X | 1999137420 | MO | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Public Health & General Preventive Medicine |
No ID Information.