Individual
EDWARD JOSEPH KANIVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
5165 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 488-8000
(765) 868-4698
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(765) 747-4492
(317) 222-2126
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02005998A
IN
207R00000X
Internal Medicine Physician
125069970
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300038350
—
IN
Enumeration date
03/22/2017
Last updated
07/09/2020
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