Individual
KANDICE K LUDWIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11725 N ILLINOIS STREET, SUITE 545, CARMEL, IN 46032-3014
(317) 688-3220
(317) 688-5150
Mailing address
250 N SHADELAND AVE, STE 130, PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
(317) 963-0860
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01068492A
IN
208600000X
Surgery Physician
4301060249
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000675954
ANTHEM PIN
IN
05
—
200988110
—
IN
Enumeration date
07/03/2007
Last updated
01/28/2021
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