Healthcare Provider Details

I. General information

NPI: 1164495644
Provider Name (Legal Business Name): GERALDINE A DARROCA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 03/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11911 N MERIDIAN ST SUITE 110
CARMEL IN
46032-6919
US

IV. Provider business mailing address

6626 E. 75TH STREET SUITE 500
INDIANAPOLIS IN
46250-2890
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-1151
  • Fax: 317-621-1179
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01037586A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: