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NPI Code Detail

MEDICARE: ANDREW SCOTT GUDEMAN MD

MEDICARE: ANDREW SCOTT GUDEMAN 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
1207X00000XOrthopaedic Surgery Physician01096401AIN
2207XX0005XSports Medicine (Orthopaedic Surgery) Physician01096401AIN

General Provider Information

NPI Number : 1053974733
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW SCOTT GUDEMAN MD
Provider Business Mailing Address
First Line : 8450 NORTHWEST BLVD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46278-1381
Country : US
Telephone Number : 317-802-2000
Fax Number : 317-802-2050
Provider Business Practice Location Address
First Line : 1260 INNOVATION PKWY STE 100
Second Line :
City : GREENWOOD
State : IN
Zip : 46143-3602
Country : US
Telephone Number : 317-884-5200
Fax Number : 317-884-5360
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2019
Last Update Date : 02/13/2026

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