Doctor Name: | DANIEL R CORSON-KNOWLES |
NPI Number: | 1073951497 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 11017213A |
Business Practice Address: | 1701 N Senate Blvd Ag012 Indianapolis, IN - 462021239 |
Business Phone Number: | 3179625975 |
Business Fax Number: | 3179625394 |
Mailing Address: | 1701 N Senate Blvd, Ag012 INDIANAPOLIS |
State: | IN |
Postal Code: | 462021239 |
Phone Number: | 3179625975 |
Fax Number: | 3179625394 |
NPI Enumeration Date: | 06/07/2013 |
NPI Last Update Date: | 05/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 11017213A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |