Healthcare Provider Details

I. General information

NPI: 1861114837
Provider Name (Legal Business Name): KEVIN PATRICK FREBEL PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2022
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 N SENATE BLVD STE 535
INDIANAPOLIS IN
46202-1204
US

IV. Provider business mailing address

10767 ILLINOIS ST STE 3000
CARMEL IN
46032-8972
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-9400
  • Fax: 317-963-1955
Mailing address:
  • Phone: 317-817-1200
  • Fax: 317-817-1220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10004375A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: