Individual
MARCELA CHACON DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1801 N SENATE BLVD, SUITE 400, INDIANAPOLIS, IN 46202-1228
(317) 962-5581
(317) 962-5859
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01075686A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000965920
ANTHEM COMMERCIAL
IN
05
—
201124790
—
IN
Enumeration date
04/12/2011
Last updated
05/19/2025
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