Individual
MARY MCCALLISTER CARVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7120 CLEARVISTA DRIVE, SUITE 2100, INDIANAPOLIS, IN 46256-0020
(317) 621-2740
(317) 621-5658
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01071765A
IN
208M00000X
Hospitalist Physician
7590715-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201111350
—
IN
01
—
P01214630
RR MEDICARE PTAN
IN
01
—
P01247388
RR MEDICARE PTAN
IN
Enumeration date
04/15/2008
Last updated
03/05/2014
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