Provider Demographics
NPI:1174600688
Name:CEH, PAULA (PA)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:CEH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:STE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1426 MAIN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-6526
Practice Address - Country:US
Practice Address - Phone:317-486-2350
Practice Address - Fax:317-486-2356
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00559363A00000X
IN1001044A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP01539668OtherRAILROAD PTAN
INP01405396OtherRAILROAD MEDICARE
INP01405396OtherRAILROAD MEDICARE
NCPENDINGMedicare UPIN