MEDICARE: PIKE MEDICAL CONSULTANTS EXPEDITE

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
3	363A00000X	Physician Assistant
4	363L00000X	Nurse Practitioner
5	363LA2200X	Adult Health Nurse Practitioner
6	363LF0000X	Family Nurse Practitioner
7	207RP1001X	Pulmonary Disease Physician

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DF5450	OTHER	IN	RAILRAOD MEDICARE GROUP

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1730332032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIKE MEDICAL CONSULTANTS EXPEDITE

Provider Business Mailing Address
First Line	:	6040 W 84TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-1360
Country	:	US
Telephone Number	:	317-956-6288
Fax Number	:	317-956-6289

Provider Business Practice Location Address
First Line	:	4126 E 10TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-2613
Country	:	US
Telephone Number	:	317-956-6288
Fax Number	:	317-956-6289

Authorized Official
Title or Position	:	PRESIDENT/PHYSICIAN
Name	:	JAMES D PIKE
Credential	:	DO
Telephone Number	:	317-956-6288

Provider Enumeration Date	:	10/30/2008
Last Update Date	:	11/10/2008

4130 E 10TH ST
INDIANAPOLIS, IN
46201-2613

Practice Phone: 317-359-7244
Practice Fax: 317-359-0248