Individual
JOHN WILLIAM FANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 W MICHIGAN ST # CL642, INDIANAPOLIS, IN 46202-5209
(317) 278-2686
Mailing address
1120 W MICHIGAN ST # CL642, INDIANAPOLIS, IN 46202-5209
(317) 278-2686
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301513777
MI
Other
Enumeration date
04/12/2021
Last updated
07/30/2025
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