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Individual

DR. MICHAEL SHANNON TODD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3125 S SCATTERFIELD RD STE 210, ANDERSON, IN 46013
(765) 298-4311
(765) 298-4312
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
02002715A
IN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
02002715A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300014911
IN
Enumeration date
01/11/2007
Last updated
06/13/2023
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