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NPI Code Detail

MEDICARE: JUSTINA M GIROD MD

MEDICARE: JUSTINA M GIROD 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
1207Q00000XFamily Medicine Physician01058149AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00967448OTHERINRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
21100065412OTHERINANTHEM PTAN
3000000359608OTHERBLUE CROSS BLUE SHIELD
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497746895
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTINA M GIROD 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 : 3534 BROOKLYN AVE
Second Line :
City : FORT WAYNE
State : IN
Zip : 46809-1361
Country : US
Telephone Number : 260-478-5250
Fax Number : 260-478-5258
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2005
Last Update Date : 12/30/2024

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