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Individual
CANDACE L EMBRY
Active
Individual
CANDACE L EMBRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01033360
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0102233
UNITED HEALTHCARE
IN
01
—
080005769
MEDICARE RAILROAD
IN
05
—
100128200A
—
IN
01
—
1017630001
DMERC
—
01
—
338888P
SIHO
IN
01
—
351920057
GROUP TAX ID#
IN
01
—
42637
ANTHEM
IN
Enumeration date
06/08/2006
Last updated
12/04/2020
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