Healthcare Provider Details

I. General information

NPI: 1518891100
Provider Name (Legal Business Name): CAMERON MCNELIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1599 TOWNSHIP LINE RD
PLAINFIELD IN
46168-7517
US

IV. Provider business mailing address

1599 TOWNSHIP LINE RD
PLAINFIELD IN
46168-7517
US

V. Phone/Fax

Practice location:
  • Phone: 317-914-3176
  • Fax: 844-742-8592
Mailing address:
  • Phone: 317-914-3176
  • Fax: 844-742-8592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: