Healthcare Provider Details

I. General information

NPI: 1700405636
Provider Name (Legal Business Name): BRENNA MICHELLE MCELDERRY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2020
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10590 N MERIDIAN ST STE 200
CARMEL IN
46290-1028
US

IV. Provider business mailing address

10590 N MERIDIAN ST STE 200
CARMEL IN
46290-1028
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-6666
  • Fax: 317-338-6066
Mailing address:
  • Phone: 317-338-6666
  • Fax: 317-338-6066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number01099386A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: