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General NPI Number Information
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NPI Number | 1134128549
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Entity Type | Individual
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Provider Name | ANETTE C. LANE MD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 8244 E US HIGHWAY 36 STE 1320
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City | AVON
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State | IN
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Zip | 46123-9688
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Country | US
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Telephone | 317-272-7519
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Fax | 317-272-3661
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Provider Business Mailing Address
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Address Line | 6300 SOUTHEASTERN AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46203-5828
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Country | US
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Telephone | 317-803-2515
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Fax | 317-803-2519
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01054524A
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License Number State | IN
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