MEDICARE: DAVID P LLOYD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	01025396A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00755201	OTHER	IN	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	000000595621	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1003816711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID P LLOYD MD

Provider Business Mailing Address
First Line	:	11109 PARKVIEW PLAZA DR # 117
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1701
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11108 PARKVIEW CIRCLE DR
Second Line	:	SUITE 5100
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1730
Country	:	US
Telephone Number	:	260-266-2800
Fax Number	:	260-266-2805

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	10/17/2022

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Directions to “ DAVID P LLOYD MD” Practice Location

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