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Individual

NICHOLAS MORGAN RADELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1701 SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-2848
(317) 962-3916
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003947A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
267030302
MEDICARE PTAN
IN
05
300073146
IN
Enumeration date
02/21/2023
Last updated
02/15/2025
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