MEDICARE: DR. NALINI A BANGALORE 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	207R00000X	Internal Medicine Physician	01054007	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	:	1669413043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NALINI A BANGALORE MD

Provider Business Mailing Address
First Line	:	8535 N CLEARVIEW DR
Second Line	:	STE 400
City	:	MCCORDSVILLE
State	:	IN
Zip	:	46055-6240
Country	:	US
Telephone Number	:	317-335-6930
Fax Number	:	317-335-5030

Provider Business Practice Location Address
First Line	:	8535 N CLEARVIEW DR
Second Line	:	STE 400
City	:	MCCORDSVILLE
State	:	IN
Zip	:	46055-6240
Country	:	US
Telephone Number	:	317-335-6930
Fax Number	:	317-335-5030

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	05/25/2016

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