Provider Demographics
NPI:1457838450
Name:CARMEL PEDIATRICS, LLC
Entity Type:Organization
Organization Name:CARMEL PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:GEORGINA
Authorized Official - Last Name:GILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-582-7257
Mailing Address - Street 1:13450 N MERIDIAN ST STE 260
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1485
Mailing Address - Country:US
Mailing Address - Phone:317-582-7875
Mailing Address - Fax:317-582-7413
Practice Address - Street 1:13450 N MERIDIAN ST STE 260
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1485
Practice Address - Country:US
Practice Address - Phone:317-582-7875
Practice Address - Fax:317-582-7413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty