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Individual

ELDRED HUGH MACDONELL JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1400 N. RITTER AVE., SUITE 370, INDIANAPOLIS, IN 46219-3098
(317) 355-1144
(317) 355-1155
Mailing address
12031 EDGEFIELD DR, FISHERS, IN 46037-3826

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01042438A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000793547
ANTHEM
IN
05
100474160
IN
05
100474160A
IN
01
P01157058
MEDICARE RAILROAD
IN
Enumeration date
03/03/2006
Last updated
01/05/2024
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