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Individual

DR. BRADLEY CARQUEVILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
2040 N SHADELAND AVE STE 130, INDIANAPOLIS, IN 46219-1727
(317) 355-7627
Mailing address
2040 N SHADELAND AVE STE 130, INDIANAPOLIS, IN 46219-1727

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
051300475
IL
183500000X
Pharmacist
Primary
26027034A
IN

Other

Enumeration date
08/14/2017
Last updated
08/02/2019
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