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NPI Code Detail

MEDICARE: WALTER DANIEL HARBIN

MEDICARE:   WALTER DANIEL HARBIN
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
1172V00000XCommunity Health Worker26023900AIN

General Provider Information

NPI Number : 1114883782
Entity Type Code : Individual
Provider Name (Legal Business Name) : WALTER DANIEL HARBIN
Provider Business Mailing Address
First Line : 5678 WINTHROP AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46220-3265
Country : US
Telephone Number : 248-670-8578
Fax Number : 317-257-6847
Provider Business Practice Location Address
First Line : 6191 N KEYSTONE AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46220-2423
Country : US
Telephone Number : 317-257-6746
Fax Number : 317-257-6847
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2025
Last Update Date : 12/29/2025

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