Individual
MICHAEL ANTHONY ACQUAVIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 944-9981
(317) 944-8699
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01066743A
IN
207L00000X
Anesthesiology Physician
036.119149
IL
207LP3000X
Pediatric Anesthesiology Physician
Primary
01066743A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000657692
ANTHEM
IN
05
—
200989720
—
IN
Enumeration date
06/26/2008
Last updated
01/27/2026
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