MEDICARE: ANGELA T CARBONE M.D.

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	208100000X	Physical Medicine & Rehabilitation Physician	01046887	IN

Other Identifiers

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

General Provider Information

NPI Number	:	1184688186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA T CARBONE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 44994
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46244-0994
Country	:	US
Telephone Number	:	317-274-4402
Fax Number	:	317-274-5168

Provider Business Practice Location Address
First Line	:	355 W 16TH ST
Second Line	:	SUITE 4300
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-2207
Country	:	US
Telephone Number	:	317-963-7077
Fax Number	:	317-963-7068

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

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	09/05/2013

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Directions to “ ANGELA T CARBONE M.D.” Practice Location

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