Daniel Fagan, MD | |
1520 N Senate Ave, Indianapolis, IN 46202-2213 | |
(317) 962-8893 | |
(317) 962-1048 |
Full Name | Daniel Fagan |
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Gender | Male |
Speciality | Internal Medicine |
Location | 1520 N Senate Ave, 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 |
---|---|---|---|
1831156330 | NPI | - | NPPES |
200013910 | Medicaid | IN | |
000000363213 | Other | IN | ANTHEM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 01041566A (Indiana) | Primary |
Entity Name | University Family Physicians, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043275787 PECOS PAC ID: 7911992797 Enrollment ID: O20040420000393 |
Entity Name | Indiana University Health Care Associates Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902032832 PECOS PAC ID: 5799755864 Enrollment ID: O20040727000955 |
Mailing Address | Practice Location Address |
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Daniel Fagan, MD 250 N Shadeland Ave, Ste 130 - Provider Enrollment, Indianapolis, IN 46219-4959 Ph: () - | Daniel Fagan, MD 1520 N Senate Ave, Indianapolis, IN 46202-2213 Ph: (317) 962-8893 |
Irene A Carrothers, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1701 Senate Blvd, Indianapolis, IN 46202 Phone: 317-963-8776 Fax: 317-963-5285 | |
Liam P Howley, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 1001 West 10th St Opw-m200, Indiana University Department Of Medicine, Indianapolis, IN 46202 Phone: 317-630-6560 | |
Cristina Nancy Perez Chumbiauca, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 550 University Blvd, Indianapolis, IN 46202 Phone: 317-944-5000 | |
Dr. Andrew Jonathen Ortega, DO Internal Medicine Medicare: Medicare Enrolled Practice Location: 702 Rotary Cir, Indianapolis, IN 46202 Phone: 317-278-4427 | |
Lawrence John Born, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 8424 Naab Rd, #3-j, Indianapolis, IN 46260 Phone: 317-872-7396 Fax: 317-879-8328 | |
Brian T Robinson, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1001 W 10th St, Indianapolis, IN 46202 Phone: 317-630-7979 Fax: 317-630-2668 | |
Steven T Hugenberg, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 550 University Blvd, Indianapolis, IN 46202 Phone: 317-944-8660 |