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General NPI Number Information
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NPI Number | 1558451740
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Entity Type | Individual
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Provider Name | DAVID JOHN DEBROTA M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 01/12/2016
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Provider Practice Location Address
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Address Line | LILLY CORPORATE CTR
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City | INDIANAPOLIS
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State | IN
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Zip | 46285-0001
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Country | US
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Telephone | 317-276-3239
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Fax | 317-433-2815
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Provider Business Mailing Address
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Address Line | LILLY CORPORATE CTR
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City | INDIANAPOLIS
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State | IN
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Zip | 46285-8363
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Country | US
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Telephone | 317-457-9960
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Fax | 317-433-2815
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01033476A
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License Number State | IN
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