Individual
DR. CHARLES E.N. KINSELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6047 BROKENHURST RD, INDIANAPOLIS, IN 46220-4987
(317) 726-1213
Mailing address
6047 BROKENHURST RD, INDIANAPOLIS, IN 46220-4987
(317) 726-1213
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01041688A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01041688A
IN
207RP1001X
Pulmonary Disease Physician
Primary
01041688
IN
207RP1001X
Pulmonary Disease Physician
R3M79
MO
207RS0012X
Sleep Medicine (Internal Medicine) Physician
01041688A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000349806
PROVIDER ANTHEM PIN
IN
05
—
100218260A
—
IN
01
—
201764827
PROVIDER CORP PIN
IN
01
—
P00183318
PROVIDER RAILROAD PIN
IN
Enumeration date
05/01/2006
Last updated
08/01/2024
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