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NPI Code Detail

MEDICARE: CARLOS A GAMBIRAZIO MD

MEDICARE: CARLOS A GAMBIRAZIO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician01046677AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
28155500582OTHERINMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000000282913OTHERINANTHEM PROVIDER NUMBER

General Provider Information

NPI Number : 1033187125
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLOS A GAMBIRAZIO MD
Provider Business Mailing Address
First Line : 250 N SHADELAND AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-4959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2600 GREENBUSH ST
Second Line :
City : LAFAYETTE
State : IN
Zip : 47904-2479
Country : US
Telephone Number : 765-448-8000
Fax Number : 765-448-7624
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 10/17/2023

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Directions to “ CARLOS A GAMBIRAZIO MD” Practice Location

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