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NPI Code Detail

MEDICARE: SALVATORE G VITALE MD

MEDICARE: SALVATORE G VITALE 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
1207L00000XAnesthesiology Physician174575-1NY
2207L00000XAnesthesiology Physician01088771AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1M122404072OTHERINMEDICARE PTAN
2264430G39OTHERINMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043215353
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALVATORE G VITALE MD
Provider Business Mailing Address
First Line : 250 N SHADELAND AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-4959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1701 N SENATE BLVD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-1239
Country : US
Telephone Number : 317-577-4200
Fax Number : 317-577-9503
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 09/28/2023

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Directions to “ SALVATORE G VITALE MD” Practice Location

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