SearchIndiana1835P0018X

Samuel Son

NPI 1265940167 · on the registry since 2018 · sole proprietor

Practice

Address
5911 Madison Ave
Indianapolis, IN 46227
Phone
(317) 791-3545
Organisation at this address
Kroger Limited Partnership I
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
1835P0018X
1835P0018X
Also registered as
390200000X
Licence states on file
IN
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-05-09

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana