MEDICARE: AMBROSIO ARANAS DOSADO 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	207Q00000X	Family Medicine Physician	01044052A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000296072	OTHER	IN	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588780779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBROSIO ARANAS DOSADO M.D.

Provider Business Mailing Address
First Line	:	3048 LAKESIDE DR
Second Line	:
City	:	HIGHLAND
State	:	IN
Zip	:	46322-3470
Country	:	US
Telephone Number	:	219-922-1581
Fax Number	:

Provider Business Practice Location Address
First Line	:	3847 EUCLID AVE
Second Line	:
City	:	EAST CHICAGO
State	:	IN
Zip	:	46312-2332
Country	:	US
Telephone Number	:	219-398-0700
Fax Number	:

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	09/16/2019

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