Healthcare Provider Details

I. General information

NPI: 1619891264
Provider Name (Legal Business Name): MADISON E UNGER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 AVON MKTPL STE 200
AVON IN
46123-6021
US

IV. Provider business mailing address

679 E COUNTY LINE RD
GREENWOOD IN
46143-1049
US

V. Phone/Fax

Practice location:
  • Phone: 317-671-8032
  • Fax: 317-671-8033
Mailing address:
  • Phone: 317-890-2000
  • Fax: 317-859-7220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: