Gandionco, Roger B
Gandionco, Roger B is an individual health care provider with primary practice located at 1500 Darlington Ave Suite 300, Crawfordsville IN 47933-2060. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gandionco, Roger B can be contacted via phone (765) 362-4940.Contact Information
Primary practice address
1500 Darlington Ave Suite 300
Crawfordsville IN 47933-2060
Phone: (765) 362-4940
Fax: (765) 362-1302
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | BP10030957 | Texas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01069499A | Indiana |
Profile Details
| NPI number | 1851553796 |
|---|---|
| LBN Legal business name | Gandionco, Roger B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 1st, 2008 |
| Last updated | Dec 16th, 2021 - 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 | 1851553796 | NPPES |
| Indiana | MEDICAID | 201026170 | |
| Indiana | Other | M400075748 |
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