Individual
CHRISTINA DIANE BOCCONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11590 N MERIDIAN ST STE 170, CARMEL, IN 46032-6963
(317) 848-3040
Mailing address
317 ARBORGLEN DR, BROWNSBURG, IN 46112-7746
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01065966A
IN
208000000X
Pediatrics Physician
01065966B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201117470
—
IN
01
—
P01588211
RR MEDICARE
IN
Enumeration date
07/11/2007
Last updated
11/09/2021
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