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General NPI Number Information
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NPI Number | 1265654818
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Entity Type | Individual
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Provider Name | CARLA M MAXWELL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 950 N. MERIDIAN STREET
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City | INDIANAPOLIS
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State | IN
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Zip | 46204
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Country | US
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Telephone | 317-962-1746
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Fax | 317-962-2030
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Provider Business Mailing Address
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Address Line | 5833 DAPPLE TRACE
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City | INDIANAPOLIS
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State | IN
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Zip | 46228
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Country | US
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Telephone | 317-280-0294
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26021010A
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License Number State | IN
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