Individual
BRENDAN MICHAEL RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
10122 E 10TH ST STE 230, INDIANAPOLIS, IN 46229-2664
(317) 355-7356
Mailing address
10122 E 10TH ST STE 230, INDIANAPOLIS, IN 46229-2664
(317) 355-7356
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
41000475A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300077951
—
IN
Enumeration date
02/17/2020
Last updated
07/20/2023
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