Provider Demographics
NPI:1730138439
Name:CARY, NORMAN S II (MD)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:S
Last Name:CARY
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:STE 130 PROVIDER ENROLLMENT
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1115 RONALD REAGAN PKWY
Practice Address - Street 2:SUITE 206
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-6911
Practice Address - Country:US
Practice Address - Phone:317-272-8050
Practice Address - Fax:317-272-8051
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2014-01-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01058858A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200474590Medicaid
INP00871843Medicare PIN
IN267030TMedicare PIN
INP00290241Medicare PIN
IN165460EEEEMedicare PIN
IN200474590Medicaid