Individual
KEVIN MICHAEL MCNULTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8051 S EMERSON AVE STE 250, INDIANAPOLIS, IN 46237-8637
(317) 528-6670
(317) 528-6671
Mailing address
PO BOX 781076, DETROIT, MI 48278-1008
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02005673A
IN
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
02005673A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/02/2017
Last updated
03/24/2026
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