Charles Phillip Blair Vanderpool, MD | |
705 Riley Hospital Dr, Roc 4210, Indianapolis, IN 46202-5109 | |
(317) 944-3774 | |
(317) 944-8521 |
Full Name | Charles Phillip Blair Vanderpool |
---|---|
Gender | Male |
Speciality | Pediatrics - Pediatric Gastroenterology |
Location | 705 Riley Hospital Dr, Indianapolis, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033266820 | NPI | - | NPPES |
201020420 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0206X | Pediatrics - Pediatric Gastroenterology | 01069261A (Indiana) | Primary |
Entity Name | University Pediatric Associates, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457396541 PECOS PAC ID: 2163326794 Enrollment ID: O20031125000021 |
Mailing Address | Practice Location Address |
---|---|
Charles Phillip Blair Vanderpool, MD Po Box 1026, Indianapolis, IN 46206-1026 Ph: (317) 274-1201 | Charles Phillip Blair Vanderpool, MD 705 Riley Hospital Dr, Roc 4210, Indianapolis, IN 46202-5109 Ph: (317) 944-3774 |
Mohannad Moallem, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 705 Riley Hospital Dr, Indianapolis, IN 46202 Phone: 317-274-4779 Fax: 317-948-9806 | |
Tracey Wilkinson, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 705 Riley Hospital Dr Ste 1300, Indianapolis, IN 46202 Phone: 317-962-8067 | |
Samuel J Flanders, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 250 N Shadeland Ave, Ste 200, Indianapolis, IN 46219 Phone: 317-962-4836 Fax: 317-962-8646 | |
Mark H Hoyer, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 705 Riley Hospital Dr, Rr 127, Indianapolis, IN 46202 Phone: 317-274-8906 Fax: 317-274-4022 | |
Dr. Alka Khaitan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 705 Riley Hospital Dr Rr230, Indianapolis, IN 46202 Phone: 317-944-7260 | |
Dr. Leslie Anne Enane, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 705 Riley Hospital Dr, Indianapolis, IN 46202 Phone: 317-944-7260 Fax: 317-948-0860 | |
Christine Nix, Pediatrics Medicare: Medicare Enrolled Practice Location: 750 Riley Hospital Drive, Room 5867, Indianapolis, IN 46202 Phone: 317-944-4034 |