Basic Information
| Provider Information | |||||||||
| NPI: | 1366446783 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STARSIAK | ||||||||
| FirstName: | CASIMIR | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6626 E 75TH ST | ||||||||
| Address2: | STE 500 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462502805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3176217584 | ||||||||
| FaxNumber: | 3179572705 | ||||||||
| Practice Location | |||||||||
| Address1: | 3660 GUION RD | ||||||||
| Address2: | STE 310 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462221697 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3176445005 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2005 | ||||||||
| LastUpdateDate: | 09/25/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 02000726A | IN | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 100356220 | 05 | IN | MEDICAID | 000000639283 | 01 | IN | ANTHEM | OTHER | P01424273 | 01 | IN | RAIL ROAD PTAN | OTHER |