Basic Information
| Provider Information | |||||||||
| NPI: | 1023221801 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DORAN | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13345 ILLINOIS ST | ||||||||
| Address2: | |||||||||
| City: | CARMEL | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460323318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173961328 | ||||||||
| FaxNumber: | 3173523417 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 AVON MARKET PL STE 100 | ||||||||
| Address2: | |||||||||
| City: | AVON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461236021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173961300 | ||||||||
| FaxNumber: | 3173961395 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2007 | ||||||||
| LastUpdateDate: | 04/25/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 04/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | 01066370 | IN | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207L00000X | 036120703 | IL | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 2004015938 | MO | N | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 000000617057 | 01 | ANTHEM BCBS | OTHER | 200938930 | 05 | IN | MEDICAID |