Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 01061580A | IN |
N | 2080N0001X | Neonatal-Perinatal Doctor | MD 056891L | PA |
NPI | 1053301143 |
---|---|
Provider Name | Dr. Caroline Ann Maylock |
First Address | Indianapolis, IN 46260-5392 |
Second Address | Indianapolis, IN 46260-2479 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1053301143 | (02) |