1356325187 NPI number — ROBERT M MENEGHINI MD

Table of content: ROBERT M MENEGHINI MD (NPI 1356325187)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356325187 NPI number — ROBERT M MENEGHINI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MENEGHINI
Provider First Name:
ROBERT
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356325187
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/31/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
950 N MERIDIAN ST
Provider Second Line Business Mailing Address:
STE 500
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46204-3908
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-962-4944
Provider Business Mailing Address Fax Number:
317-962-4950

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 W 103RD ST
Provider Second Line Business Practice Location Address:
STE 1400
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46290-1018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-688-5980
Provider Business Practice Location Address Fax Number:
317-566-2736
Provider Enumeration Date:
12/05/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  01059735A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XS0114X , with the licence number: 01059735 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207X00000X , with the licence number: 046288 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2555480 . This is a "UHC" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: P01002398 . This is a "RAILROAD MEDICARE PTAN" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: M400021360 . This is a "MEDICARE PTAN" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200985760 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000373182 . This is a "BCBS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 7262751 . This is a "AETNA" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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