Healthcare Provider Details

I. General information

NPI: 1720906613
Provider Name (Legal Business Name): CAMERON COFFING
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6845 RAMA DR
INDIANAPOLIS IN
46219-1707
US

IV. Provider business mailing address

6845 RAMA DR
INDIANAPOLIS IN
46219-1707
US

V. Phone/Fax

Practice location:
  • Phone: 317-948-1917
  • Fax: 317-948-1965
Mailing address:
  • Phone: 317-948-1917
  • Fax: 317-948-1965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number26024636A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: