Basic Information
| Provider Information | |||||||||
| NPI: | 1124280979 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ELMAN | ||||||||
| FirstName: | ARNOLFO | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1040 SIERRA DR STE 400 | ||||||||
| Address2: | |||||||||
| City: | GREENWOOD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461437241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3175284800 | ||||||||
| FaxNumber: | 3178651479 | ||||||||
| Practice Location | |||||||||
| Address1: | 1201 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CROWN POINT | ||||||||
| State: | IN | ||||||||
| PostalCode: | 46307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2197382100 | ||||||||
| FaxNumber: | 2196816867 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2008 | ||||||||
| LastUpdateDate: | 03/17/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036129021 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 60157 | WI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MT194020 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 60157 | WI | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 01070435A | IN | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 201188700 | 05 | IN | MEDICAID |