Individual
MICHAEL MARK HUNTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
253 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1501
(765) 448-8000
(765) 448-7606
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01038150A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000184666
ANTHEM PROVIDER NUMBER
IN
05
—
100262370
—
IN
01
—
10825305
CAQH NUMBER
IN
01
—
9397173
PHCS PID NUMBER
IN
05
—
HU91988035
—
IN
Enumeration date
03/16/2006
Last updated
01/14/2021
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