MEDICARE: NATALIA REBORIDO CAMPOY 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
1	207RC0000X	Cardiovascular Disease Physician	01088034A	IN
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1063973063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIA REBORIDO CAMPOY 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	:	1801 N SENATE BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-1228
Country	:	US
Telephone Number	:	317-962-0527
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2019
Last Update Date	:	12/09/2025

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