Healthcare Provider Details

I. General information

NPI: 1649569419
Provider Name (Legal Business Name): RACHEL KOCHERT DUNN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2011
Last Update Date: 06/20/2022
Certification Date: 06/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8402 HARCOURT RD STE 402
INDIANAPOLIS IN
46260-2053
US

IV. Provider business mailing address

8402 HARCOURT RD STE 402
INDIANAPOLIS IN
46260-2053
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-9450
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01078161A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number59889
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number01078161A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: