Basic Information
| Provider Information | |||||||||
| NPI: | 1427154855 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUANT-CALLENDER | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | MANUELLA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6626 E 75TH ST | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462502805 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1629 MEDICAL ARTS BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ANDERSON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460113454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7652985439 | ||||||||
| FaxNumber: | 7652984920 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 02/06/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 01057773A | IN | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 200482290B | 05 | IN | MEDICAID | P01723983 | 01 | IN | RR MEDICARE | OTHER | 200482290 | 05 | IN | MEDICAID |