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General NPI Number Information
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NPI Number | 1285632992
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Entity Type | Individual
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Provider Name | MICHAEL J DEAL M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 8122 MADISON AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-6076
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Country | US
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Telephone | 317-884-1752
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Fax | 317-884-1753
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Provider Business Mailing Address
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Address Line | 8122 MADISON AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-6076
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Country | US
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Telephone | 317-884-1752
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Fax | 317-884-1753
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 01024942A
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License Number State | IN
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