Provider Demographics
NPI:1710113634
Name:MICHEL, MICHAEL D (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:MICHEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:950 N. MERIDIAN ST
Mailing Address - Street 2:STE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-3908
Mailing Address - Country:US
Mailing Address - Phone:317-962-4942
Mailing Address - Fax:317-962-4950
Practice Address - Street 1:1701 N SENATE BLVD
Practice Address - Street 2:ROOM DG412
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1239
Practice Address - Country:US
Practice Address - Phone:317-962-3886
Practice Address - Fax:317-963-5492
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2013-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01070422A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201101570Medicaid
IN201101570Medicaid