Individual
MICHAEL PAVELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5406 W 38TH ST, INDIANAPOLIS, IN 46254-2918
(219) 242-2423
Mailing address
2705 PRENTISS DR, VALPARAISO, IN 46385-2894
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003991AB
IN
Other
Enumeration date
07/23/2016
Last updated
07/23/2016
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