Ciccarelli, Mary

Ciccarelli, Mary is an individual health care provider with primary practice located at 2505 N Arlington Ave , Indianapolis IN 46218-3318. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Ciccarelli, Mary can be contacted via phone (317) 554-5200.

Contact Information

Primary practice address
2505 N Arlington Ave Indianapolis IN 46218-3318
Phone: (317) 554-5200
Fax: (317) 554-5247
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 01039620A Indiana
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01039620A Indiana

Profile Details

NPI number 1538126057
LBN Legal business name Ciccarelli, Mary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2006
Last updated Mar 10th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538126057 NPPES
Indiana Other 000000086725 ANTHEM
Indiana MEDICAID 100117410 ANTHEM

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