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Individual

NIKO J MCCARTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 751-2649
(765) 281-6671
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28197897A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300058657
IN
01
MEDICARE
M22404257
IN
Enumeration date
04/03/2020
Last updated
09/26/2022
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