Organization
NORTHSIDE ORTHOPAEDIC CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHEAL F. KAVENEY M.D. (PHYSICIAN/OWNER)
(317) 275-1999
Entity
Organization
Contact information
Practice address
13914 SOUTHEASTERN PKWY, SUITE 201, FISHERS, IN 46037-7127
(317) 275-1999
(317) 275-1945
Mailing address
13914 SOUTHEASTERN PKWY, SUITE 201, FISHERS, IN 46037-7127
(317) 275-1999
(317) 275-1945
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200373990A
—
IN
01
—
5506996
CIGNA
IN
Enumeration date
07/04/2006
Last updated
03/20/2015
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