Provider Demographics
NPI:1174544910
Name:MCCURDY, DWIGHT BENJAMIN (MD)
Entity type:Individual
Prefix:
First Name:DWIGHT
Middle Name:BENJAMIN
Last Name:MCCURDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:317-621-7547
Mailing Address - Fax:
Practice Address - Street 1:1210 MEDICAL ARTS BLVD STE 215
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-3439
Practice Address - Country:US
Practice Address - Phone:765-298-4140
Practice Address - Fax:765-284-2434
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01043407A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200039730AMedicaid
G06846Medicare UPIN