Individual
MICHAEL THOMAS EADON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01072331A
IN
207RN0300X
Nephrology Physician
Primary
01072331A
IN
207RN0300X
Nephrology Physician
036.127439
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000815242
ANTHEM PTAN
IN
05
—
201141170
—
IN
01
—
P01339694
RAILROAD MEDICARE
IN
Enumeration date
12/31/2008
Last updated
03/07/2025
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