Basic Information
Provider Information
NPI: 1699162131
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCCLAIN
FirstName: SARAH
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: KLEIMAN
OtherFirstName: SARAH
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 6626 E 75TH ST STE 500
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 462502890
CountryCode: US
TelephoneNumber: 3176219312
FaxNumber:  
Practice Location
Address1: 8150 OAKLANDON RD STE 130
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 46236
CountryCode: US
TelephoneNumber: 3176211111
FaxNumber: 3176211110
Other Information
ProviderEnumerationDate: 04/22/2015
LastUpdateDate: 09/16/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/16/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X TNN Student, Health CareStudent in an Organized Health Care Education/Training Program 
208000000X01080356AINY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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