Doctor Name: | MRS. MEGHAN CARLSTEDT |
NPI Number: | 1073967279 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 10002008A |
Business Practice Address: | 12050 N Michigan Rd Zionsville, IN - 460778782 |
Business Phone Number: | 3173440930 |
Business Fax Number: | |
Mailing Address: | 144 W 64th St, INDIANAPOLIS |
State: | IN |
Postal Code: | 462604206 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/14/2016 |
NPI Last Update Date: | 04/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 10002008A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |