Healthcare Provider Details

I. General information

NPI: 1487651329
Provider Name (Legal Business Name): LOUIS F. JANEIRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5330 E STOP 11 RD
INDIANAPOLIS IN
46237-6345
US

IV. Provider business mailing address

PO BOX 781076
DETROIT MI
48278-1076
US

V. Phone/Fax

Practice location:
  • Phone: 317-893-1900
  • Fax: 317-893-1901
Mailing address:
  • Phone: 317-528-4800
  • Fax: 317-865-1479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number01039218A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: