Healthcare Provider Details

I. General information

NPI: 1629822341
Provider Name (Legal Business Name): ALLISON LIZ KADAMPELIL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W 14TH ST
INDIANAPOLIS IN
46202-2369
US

IV. Provider business mailing address

350 W 14TH ST
INDIANAPOLIS IN
46202-2369
US

V. Phone/Fax

Practice location:
  • Phone: 317-274-0267
  • Fax:
Mailing address:
  • Phone: 317-274-0267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number11024752A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: