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:
Health care specialties
| Specialty | Code | License # | 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 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295792760 | NPPES |
| Indiana | MEDICAID | 200048040 |
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