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Individual

MELISSA C KNUTSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1351 RONALD REAGAN PKWY STE A, AVON, IN 46123-6764
(317) 217-2919
(317) 217-2916
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02003922A
IN
207QS0010X
Sports Medicine (Family Medicine) Physician
02003922A
IN
207R00000X
Internal Medicine Physician
02003922
IN
207R00000X
Internal Medicine Physician
Primary
02003922A
IN
208M00000X
Hospitalist Physician
2010-00476
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000729675
ANTHEM PIN
IN
05
201032610
IN
Enumeration date
05/26/2008
Last updated
03/17/2025
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