Individual
KEVIN E. MACADAEG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13225 N MERIDIAN ST, CARMEL, IN 46032-5480
(317) 228-7000
(317) 228-2321
Mailing address
13225 N MERIDIAN ST, CARMEL, IN 46032-5480
(317) 228-7000
(317) 228-2321
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
01040591A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000016705
M-PLAN PROVIDER NUMBER
IN
01
—
000000338385
ANTHEM PROVIDER NUMBER
IN
01
—
050086502
MEDICARE RAIL ROAD
IN
01
—
366735000
US DEPT. OF LABOR
IN
01
—
9450316
CIGNA PROVIDER NUMBER
IN
Enumeration date
10/02/2006
Last updated
05/27/2016
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