Organization
INDIANAPOLIS PERIOPERATIVE MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER CACCAVALLO M.D. (INTERNAL MEDICINE PHYSICIAN)
(317) 513-0538
Entity
Organization
Contact information
Practice address
13000 E 136TH ST, STE. 1100, FISHERS, IN 46037-9478
(317) 513-0538
Mailing address
13000 E 136TH ST, STE. 1100, FISHERS, IN 46037-9478
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10002130A
IN
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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