Individual
BRADLEY S GUILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8205 E 56TH ST, SUITE 100, INDIANAPOLIS, IN 46216-1056
(317) 621-4044
(317) 621-4050
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01047092A
IN
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
01047092A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000342148
ANTHEM
IN
05
—
200263180
—
IN
01
—
P00957598
RR MEDICARE
IN
Enumeration date
03/01/2006
Last updated
11/27/2023
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