Provider Demographics
NPI:1255861688
Name:CAHILL, BROOK NICOLE (MD)
Entity type:Individual
Prefix:
First Name:BROOK
Middle Name:NICOLE
Last Name:CAHILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BROOK
Other - Middle Name:NICOLE
Other - Last Name:MUNGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1646 BEACH ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-5009
Mailing Address - Country:US
Mailing Address - Phone:317-902-6526
Mailing Address - Fax:
Practice Address - Street 1:545 BARNHILL DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5112
Practice Address - Country:US
Practice Address - Phone:317-278-0394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IN01093687A208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program