Bacallao, Robert L

Bacallao, Robert L is an individual health care provider with primary practice located at 1481 W 10Th St # C3004 , Indianapolis IN 46202-2803. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Bacallao, Robert L can be contacted via phone (317) 988-2633.

Contact Information

Primary practice address
1481 W 10Th St # C3004 Indianapolis IN 46202-2803
Phone: (317) 988-2633
Fax: (317) 968-0139
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 01044965 Indiana

Profile Details

NPI number 1295792760
LBN Legal business name Bacallao, Robert L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 28th, 2006
Last updated Nov 20th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295792760 NPPES
Indiana MEDICAID 200048040

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