Provider Demographics
NPI:1154547420
Name:MAUN, DIPEN CHAMPAKLAL (MD)
Entity type:Individual
Prefix:
First Name:DIPEN
Middle Name:CHAMPAKLAL
Last Name:MAUN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:1215 HADLEY RD STE 201
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-2907
Practice Address - Country:US
Practice Address - Phone:317-834-2020
Practice Address - Fax:317-831-9467
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2023-07-11
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Provider Licenses
StateLicense IDTaxonomies
IN01063299A208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01063299AOtherPHYSICIAN LICENSE