Provider Demographics
NPI:1700354107
Name:CANTRELL, MATTHEW (DVM)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:CANTRELL
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6567 WHITESTOWN PKWY
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-7621
Mailing Address - Country:US
Mailing Address - Phone:317-344-0906
Mailing Address - Fax:317-344-0908
Practice Address - Street 1:6567 WHITESTOWN PKWY
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-7621
Practice Address - Country:US
Practice Address - Phone:317-344-0906
Practice Address - Fax:317-344-0908
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN24007044A246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE