Individual
DR. MATTHEW W CRITTENDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
(317) 274-4705
(317) 278-0943
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01058985A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200501010
—
IN
Enumeration date
08/24/2006
Last updated
01/29/2014
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