Gallardo, Rafael L

Gallardo, Rafael L is an individual health care provider with primary practice located at 1711 N 6 1/2 St Ste 200, Terre Haute IN 47804-2766. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Gallardo, Rafael L can be contacted via phone (812) 242-3610.

Contact Information

Primary practice address
1711 N 6 1/2 St Ste 200 Terre Haute IN 47804-2766
Phone: (812) 242-3610
Fax: (812) 242-3630
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 01060896A Indiana
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 36068281 Illinois

Profile Details

NPI number 1578670394
LBN Legal business name Gallardo, Rafael L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2006
Last updated Aug 18th, 2010 - about 15 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 1578670394 NPPES
Indiana MEDICAID 200524590B
Indiana MEDICAID 200524590G
Indiana MEDICAID 200524590T
Indiana Other P00834944
Indiana MEDICAID 200524590K
Indiana MEDICAID 200524590L
Indiana MEDICAID 200524590Y
Indiana MEDICAID 200524590Z
Indiana Other 000000372569
Indiana Other P00268119

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