Individual
ELLIOT H COUSINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8433 HARCOURT RD, SUITE 100, INDIANAPOLIS, IN 46260-2190
(317) 583-7702
(317) 583-7601
Mailing address
8433 HARCOURT RD, SUITE 100, INDIANAPOLIS, IN 46260-2190
(317) 583-7702
(317) 583-7601
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
01035926A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083136
BCBS PIN
—
05
—
100376130A
—
IN
01
—
60016008
RAILROAD MEDICARE PIN
—
Enumeration date
06/19/2006
Last updated
05/30/2008
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