Healthcare Provider Details

I. General information

NPI: 1013145986
Provider Name (Legal Business Name): RAFAEL SAMUEL GARCIA-CORTES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 06/22/2022
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8333 NAAB RD STE 420
INDIANAPOLIS IN
46260-1992
US

IV. Provider business mailing address

8333 NAAB RD STE 420
INDIANAPOLIS IN
46260-1992
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-6666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number01078404A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01078404A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number01078404A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2012018773
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: