MEDICARE: DR. CARYN C ANDERSON MD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	01045157	IN

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	P00275506	OTHER	IN	RRMEDICARE-351158723

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	067863	OTHER	IN	SIHO-351158723
2	Q0431310	OTHER	IN	CMOSHO351158723-352047427
3	000000492328	OTHER	IN	ANTHEM 203778927
4	000000379704	OTHER	IN	ANTHEM-351158723
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	111288	OTHER	IN	HEALTH ALLIANCE-351158723

NPI Number	:	1003801952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARYN C ANDERSON MD

Provider Business Mailing Address
First Line	:	5901 TECHNOLOGY CENTER DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-6013
Country	:	US
Telephone Number	:	317-328-4777
Fax Number	:	317-715-9965

Provider Business Practice Location Address
First Line	:	5901 TECHNOLOGY CENTER DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-6013
Country	:	US
Telephone Number	:	317-328-4777
Fax Number	:	317-715-9965

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	02/27/2024

5901 TECHNOLOGY CENTER DR
INDIANAPOLIS, IN
46278-6013

Practice Phone: 317-328-4777
Practice Fax: 317-715-9965

5901 TECHNOLOGY CENTER DR
INDIANAPOLIS, IN
46278-6013