Individual
VARON CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1522 W MORRIS ST, INDIANAPOLIS, IN 46221-1629
(317) 488-2020
(317) 488-2031
Mailing address
3401 E RAYMOND ST, INDIANAPOLIS, IN 46203-4744
(317) 788-9769
(317) 781-4868
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01067875A
IN
207R00000X
Internal Medicine Physician
57010131
OH
208000000X
Pediatrics Physician
01067875A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200957170
—
IN
Enumeration date
04/25/2007
Last updated
09/08/2011
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