MEDICARE: ANDREW CAGLE 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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	01051054A	IN
2	2080P0205X	Pediatric Endocrinology Physician	01051054A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000365393	OTHER	IN	ANTHEM
2	000000700863	OTHER	IN	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639192743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW CAGLE MD

Provider Business Mailing Address
First Line	:	7310 PREAMBLE CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46259-5751
Country	:	US
Telephone Number	:	317-371-1085
Fax Number	:

Provider Business Practice Location Address
First Line	:	7310 PREAMBLE CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46259-5751
Country	:	US
Telephone Number	:	317-371-1085
Fax Number	:

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/28/2015

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