MEDICARE: ROBERT D FICALORA 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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	01081089A	IN
2	207QG0300X	Geriatric Medicine (Family Medicine) Physician	MED-PHY-LIC-28236	MT
3	207R00000X	Internal Medicine Physician	01081089A	IN
4	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	01081089A	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	:	1568441020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT D FICALORA M.D.

Provider Business Mailing Address
First Line	:	801 SAINT MARYS DR # 300
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47714-0511
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 SAINT MARYS DR # 300
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47714-0511
Country	:	US
Telephone Number	:	812-485-5300
Fax Number	:

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

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	06/21/2022

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Directions to “ ROBERT D FICALORA M.D.” Practice Location

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