Individual
GRANT ALLAN CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11700 N MERIDIAN ST, CARMEL, IN 46032-4656
(317) 577-4200
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01072829
IN
207L00000X
Anesthesiology Physician
Primary
01072829A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11015407A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201107560
—
IN
01
—
P01424290
RAIL ROAD PTAN
IN
01
—
Q00372285
RAILROAD PTAN
IN
Enumeration date
05/26/2010
Last updated
11/26/2024
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