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NPI Code Detail

MEDICARE: DR. MONICA BRUNELLE MD

MEDICARE:  DR. MONICA  BRUNELLE  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
1207R00000XInternal Medicine Physician01024979IN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00283879OTHERINRAILROAD MEDICARE
6112568798OTHERINRAILROAD MEDICARE
11P00277621OTHERINRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
20000003897OTHERINANTHEM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
54004135OTHERINAETNA US HEALTHCARE
7314345668OTHERINTRICARE
86313463005OTHERINCIGNA HEALTHCARE
9000000343057OTHERINANTHEM BCBS
10398887OTHERINWELLCARE

General Provider Information

NPI Number : 1457468316
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MONICA BRUNELLE MD
Provider Business Mailing Address
First Line : 10122 E 10TH ST
Second Line : SUITE # 220
City : INDIANAPOLIS
State : IN
Zip : 46229-2663
Country : US
Telephone Number : 317-355-2184
Fax Number : 317-355-2185
Provider Business Practice Location Address
First Line : 10122 E 10TH ST
Second Line : SUITE # 220
City : INDIANAPOLIS
State : IN
Zip : 46229-2663
Country : US
Telephone Number : 317-355-2184
Fax Number : 317-355-2185
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2006
Last Update Date : 01/08/2009

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Directions to “ DR. MONICA BRUNELLE MD” Practice Location

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