Individual
DR. MICHAEL SCOTT WASSERSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
120 E CARMEL DR, CARMEL, IN 46032-2633
(317) 844-7000
(317) 844-3268
Mailing address
2625 OLD VINES DR, WESTFIELD, IN 46074-8533
(317) 896-3304
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001875A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000175475
ANTHEM PIN #
IN
05
—
200249330A
—
IN
Enumeration date
05/16/2006
Last updated
03/03/2008
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