MEDICARE: CANCER CARE GROUP, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician

General Provider Information

NPI Number	:	1851342497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANCER CARE GROUP, P.C.

Provider Business Mailing Address
First Line	:	6100 W 96TH ST
Second Line	:	SUITE 125
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-6005
Country	:	US
Telephone Number	:	317-715-1800
Fax Number	:	317-715-6200

Provider Business Practice Location Address
First Line	:	1215 HADLEY RD
Second Line	:	SUITE 105
City	:	MOORESVILLE
State	:	IN
Zip	:	46158-2905
Country	:	US
Telephone Number	:	317-834-5900
Fax Number	:	317-834-5223

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. THOMAS C. DUGAN
Credential	:	M.D.
Telephone Number	:	317-715-1800

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	08/12/2014

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