Healthcare Provider Details

I. General information

NPI: 1801725726
Provider Name (Legal Business Name): MICHAEL THOMAS DELONG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13500 N MERIDIAN ST
CARMEL IN
46032-1456
US

IV. Provider business mailing address

210 VETERANS WAY STE 200
CARMEL IN
46032-3391
US

V. Phone/Fax

Practice location:
  • Phone: 317-582-7300
  • Fax:
Mailing address:
  • Phone: 317-571-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number2451-7618
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number28233623A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: