MEDICARE: NEUROCARE LLC

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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1821035718
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROCARE LLC

Provider Business Mailing Address
First Line	:	30 W RAMPART ST STE 230
Second Line	:
City	:	SHELBYVILLE
State	:	IN
Zip	:	46176-8897
Country	:	US
Telephone Number	:	317-705-2000
Fax Number	:	317-705-2049

Provider Business Practice Location Address
First Line	:	2451 INTELLIPLEX DR STE 250
Second Line	:
City	:	SHELBYVILLE
State	:	IN
Zip	:	46176-8581
Country	:	US
Telephone Number	:	317-705-2000
Fax Number	:	317-705-2049

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GUST THOMAS SPENOS
Credential	:	MD
Telephone Number	:	317-705-2000

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	10/20/2020

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Directions to “NEUROCARE LLC ” Practice Location

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