MEDICARE: ROBERT E SHOEMAKER 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	01026362A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P01198087	OTHER	IN	RR MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000569473	OTHER	IN	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	399832	OTHER	IN	WELLCARE
4	4004424	OTHER	IN	AETNA

General Provider Information

NPI Number	:	1649262494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT E SHOEMAKER MD

Provider Business Mailing Address
First Line	:	6626 E 75TH ST
Second Line	:	SUITE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2805
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8075 N SHADELAND AVE
Second Line	:	SUITE 200
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2693
Country	:	US
Telephone Number	:	317-621-8500
Fax Number	:	317-621-8501

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	12/05/2014

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Directions to “ ROBERT E SHOEMAKER MD” Practice Location

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