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NPI Code Detail

MEDICARE: MR. ANIL KARIMILLA MHSPT

MEDICARE: MR. ANIL KARIMILLA MHSPT
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
1225100000XPhysical Therapist5501013619MI
2225100000XPhysical Therapist05009502AIN

General Provider Information

NPI Number : 1285819284
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANIL KARIMILLA MHSPT
Provider Business Mailing Address
First Line : 7368 QUEEN VICTORIA CT
Second Line : APT # C
City : INDIANAPOLIS
State : IN
Zip : 46227-6532
Country : US
Telephone Number : 510-325-3579
Fax Number :
Provider Business Practice Location Address
First Line : 3895 S KEYSTONE AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-3540
Country : US
Telephone Number : 510-325-3579
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2008
Last Update Date : 07/20/2011

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