Individual
COLIN DEANE DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
429 E VERMONT ST STE 110, INDIANAPOLIS, IN 46202-3685
(317) 559-0850
Mailing address
11150 LANTERN RD APT 319, FISHERS, IN 46038-2340
(317) 446-9383
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
71016312A
IN
Other
Enumeration date
09/29/2023
Last updated
04/03/2025
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