| Doctor Name: | DR. KEVIN CANTWELL |
| NPI Number: | 1679870042 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 01035263A |
| Business Practice Address: | 11715 Fox Rd # 400-227 Indianapolis, IN - 462368421 |
| Business Phone Number: | 3175366295 |
| Business Fax Number: | 3175366295 |
| Mailing Address: | 11715 Fox Rd # 400-227, INDIANAPOLIS |
| State: | IN |
| Postal Code: | 462368421 |
| Phone Number: | 3175366295 |
| Fax Number: | 3175366295 |
| NPI Enumeration Date: | 02/22/2011 |
| NPI Last Update Date: | 04/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 01035263A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |