Healthcare Provider Details

I. General information

NPI: 1861070856
Provider Name (Legal Business Name): ALEXANDER DIMITRI KARABACHEV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 UNIVERSITY BLVD STE 3170
INDIANAPOLIS IN
46202-5149
US

IV. Provider business mailing address

1130 W MICHIGAN ST
INDIANAPOLIS IN
46202-5209
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-6467
  • Fax:
Mailing address:
  • Phone: 317-274-8157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number01099329A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: