Provider Demographics
NPI:1801232558
Name:CUMMINS, DANIELLE CHRISTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:CHRISTINE
Last Name:CUMMINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 W STOP 11 ROAD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217
Mailing Address - Country:US
Mailing Address - Phone:765-586-7431
Mailing Address - Fax:
Practice Address - Street 1:1001 W 10TH STREET
Practice Address - Street 2:WEST PAVILION M200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-656-4260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11017044A390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program