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Individual

CONRAD EMERSON DEEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5255 E STOP 11 RD, SUITE 440, INDIANAPOLIS, IN 46237-6340
(317) 882-2857
(317) 882-2873
Mailing address
1801 N SENATE BLVD, SUITE 355, INDIANAPOLIS, IN 46202-1252
(317) 924-8420
(317) 924-8424

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01058716
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000336170
ANTHEM NUMBER
IN
05
200474440
IN
Enumeration date
06/30/2005
Last updated
02/23/2016
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