Individual
TAYLOR J MERRILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 944-5000
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
75000166A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103819076
ANTHEM PTAN
IN
Enumeration date
01/25/2024
Last updated
12/05/2024
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