Individual
BRETT M MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 880-7666
(317) 880-0448
Mailing address
10330 N MERIDIAN ST, SUITE 201, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01057788A
IN
208M00000X
Hospitalist Physician
01057788A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200473950
—
IN
Enumeration date
05/06/2006
Last updated
07/19/2023
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