Individual
MARTHA ANNA CANCILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 W MICHIGAN ST # CL642, INDIANAPOLIS, IN 46202-5209
(317) 278-2686
Mailing address
1120 W MICHIGAN ST # CL642, INDIANAPOLIS, IN 46202-5209
(317) 278-2686
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
01089881A
IN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/20/2020
Last updated
04/26/2024
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