Healthcare Provider Details

I. General information

NPI: 1598873390
Provider Name (Legal Business Name): CARMEL SURGICAL SPECIALISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13430 N MERIDIAN ST SUITE 275
CARMEL IN
46032-1405
US

IV. Provider business mailing address

13430 N MERIDIAN ST SUITE 275
CARMEL IN
46032-1405
US

V. Phone/Fax

Practice location:
  • Phone: 317-582-8403
  • Fax: 317-582-8448
Mailing address:
  • Phone: 317-582-8403
  • Fax: 317-582-8448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: JANE USAB
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 317-582-8403