Individual
MICHAEL P MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10801 N MICHIGAN RD, ZIONSVILLE, IN 46077-8170
(317) 344-1234
Mailing address
10801 N MICHIGAN RD, ZIONSVILLE, IN 46077-8170
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01063877
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200866330
—
IN
Enumeration date
06/13/2007
Last updated
07/25/2022
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