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Individual

MICHAEL VAUGHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RT

Contact information

Practice address
3640 CENTRAL AVE, INDIANAPOLIS, IN 46205
(317) 744-0364
Mailing address
8959 WOOSTER CT, FISHERS, IN 46038-4513
(317) 922-1501

Taxonomy

Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
30004738A
IN
227800000X
Certified Respiratory Therapist
TT17015
FL
2278C0205X
Critical Care Certified Respiratory Therapist
30004738A
IN
2278E0002X
Emergency Care Certified Respiratory Therapist
30004738A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30004738A
INDIANA PROFESSIONAL LICENSE BUREAU
IN
Enumeration date
09/19/2022
Last updated
09/19/2022
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