Healthcare Provider Details

I. General information

NPI: 1326148305
Provider Name (Legal Business Name): MICHAEL A HENRY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 PENNSYLVANIA PKWY STE 205
CARMEL IN
46280-1393
US

IV. Provider business mailing address

201 PENNSYLVANIA PKWY STE 325
CARMEL IN
46280-1398
US

V. Phone/Fax

Practice location:
  • Phone: 317-817-1800
  • Fax: 317-817-1810
Mailing address:
  • Phone: 317-817-1800
  • Fax: 317-817-1810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01039467A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number207VE0102X
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number01039467A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: