Individual
MORGAN ELAINE MARCUCCILLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-8507
(317) 968-1395
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
02006811A
IN
207R00000X
Internal Medicine Physician
125058213
IL
207R00000X
Internal Medicine Physician
DR.0055851
CO
207RN0300X
Nephrology Physician
Primary
02006811A
IN
207RN0300X
Nephrology Physician
DR.0055851
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001667978
ANTHEM PTAN
IN
01
—
125058213
STATE OF ILLINOIS
IL
05
—
300064149
—
IN
Enumeration date
07/02/2010
Last updated
03/14/2025
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