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NPI Code Detail

MEDICARE: DORIS M HARDACKER M.D.

MEDICARE: DORIS M HARDACKER 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
1207LP3000XPediatric Anesthesiology Physician01042425AIN
2207L00000XAnesthesiology Physician01042425IN

Other Identifiers

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

General Provider Information

NPI Number : 1508817503
Entity Type Code : Individual
Provider Name (Legal Business Name) : DORIS M HARDACKER M.D.
Provider Business Mailing Address
First Line : 250 N SHADELAND AVE RM 204
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-4959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 702 BARNHILL DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-5128
Country : US
Telephone Number : 317-274-0275
Fax Number : 317-567-2191
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2006
Last Update Date : 01/18/2021

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Directions to “ DORIS M HARDACKER M.D.” Practice Location

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