Individual
DR. ANDY R DILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
11725 N ILLINOIS STREET, LL050, CARMEL, IN 46032-3008
(317) 688-5626
(317) 688-5627
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02003103A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200900710
—
IN
01
—
351747218105
TRICARE
—
Enumeration date
03/04/2008
Last updated
01/28/2021
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