Healthcare Provider Details

I. General information

NPI: 1477369528
Provider Name (Legal Business Name): ARY MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12337 HANCOCK ST STE 18
CARMEL IN
46032-5885
US

IV. Provider business mailing address

12337 HANCOCK ST STE 18
CARMEL IN
46032-5885
US

V. Phone/Fax

Practice location:
  • Phone: 317-890-0600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JUAN MARTIN LOPEZ CUERVO
Title or Position: MANAGER
Credential:
Phone: 317-890-0600