Healthcare Provider Details

I. General information

NPI: 1770846008
Provider Name (Legal Business Name): DANIEL DIEP TRAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8040 CLEARVISTA PKWY STE 150
INDIANAPOLIS IN
46256-4673
US

IV. Provider business mailing address

12449 MEETING HOUSE RD
CARMEL IN
46032-7280
US

V. Phone/Fax

Practice location:
  • Phone: 317-887-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number01074638A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number01074638A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: