Individual
DANA M BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 W 10TH ST, INDIANAPOLIS, IN 46202-2859
(317) 630-7525
(317) 567-2191
Mailing address
PO BOX 6069, DEPT 110, INDIANAPOLIS, IN 46206-6069
(317) 567-2180
(317) 567-2191
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01049542
IN
207L00000X
Anesthesiology Physician
Primary
01049542A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000090443
ANTHEM PTAN
IN
05
—
200208010
—
IN
Enumeration date
04/19/2006
Last updated
11/25/2024
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