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Organization

INDIANA COMMUNITY CANCER CARE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM M DUGAN M.D. (PRESIDENT)
(317) 924-4022
Entity
Organization

Contact information

Practice address
115 W 19TH ST, INDIANAPOLIS, IN 46202-1310
(317) 924-4022
(317) 924-4233
Mailing address
PO BOX 1326, INDIANAPOLIS, IN 46206-1326
(317) 833-1208
(317) 833-1220

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
50002564A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100311840A
IN
Enumeration date
02/07/2006
Last updated
09/17/2010
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