Provider Demographics
NPI:1427154855
Name:QUANT-CALLENDER, TERESA MANUELLA (MD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:MANUELLA
Last Name:QUANT-CALLENDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1629 MEDICAL ARTS BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-3454
Practice Address - Country:US
Practice Address - Phone:765-298-5439
Practice Address - Fax:765-298-4920
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01057773A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200482290BMedicaid
INP01723983OtherRR MEDICARE
IN200482290Medicaid
IN266180730Medicare UPIN
INP01723983OtherRR MEDICARE
IN200482290Medicaid