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General NPI Number Information
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NPI Number | 1013576784
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Entity Type | Individual
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Provider Name | VARUN VANKA MD
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Gender | Male
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 1800 NORTH CAPITOL AVENUE SUITE E371
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-1218
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Country | US
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Telephone | 346-387-1275
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Fax | 346-387-1275
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Provider Business Mailing Address
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Address Line | 530 NE GLEN OAK AVE
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City | PEORIA
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State | IL
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Zip | 61637-0001
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Country | US
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Telephone | 346-387-1275
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Fax | 309-655-3297
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 0109661B
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0109661B
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License Number State | IN
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