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Individual

KAREN N CREVIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1701 N SENATE BLVD, RM AG 001, INDIANAPOLIS, IN 46202-1239
(317) 962-3886
(317) 962-8652
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01064043
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000643518
ANTHEM
IN
05
200943110
IN
01
P00804023
RRMEDICARE
IN
Enumeration date
06/13/2007
Last updated
02/04/2021
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