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Individual

RANDALL L CALDWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
705 RILEY HOSPITAL DR, RR 127, INDIANAPOLIS, IN 46202-5109
(317) 274-8906
(317) 274-4022
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 274-1201
(317) 278-9905

Taxonomy

Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
01023836
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000354895
ANTHEM-DEAC-350593390
05
0472902
OH
05
100061190
IN
05
1073621033
MI
01
350593390-042
TRICARE-DEAC-350593390
05
64882236
KY
Enumeration date
08/29/2006
Last updated
09/17/2012
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