Basic Information
Provider Information
NPI: 1457308801
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARZIALE
FirstName: VINCENT
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6626 E. 75TH STREET
Address2: SUITE 500
City: INDIANAPOLIS
State: IN
PostalCode: 462502890
CountryCode: US
TelephoneNumber: 3174971920
FaxNumber: 3174971919
Practice Location
Address1: 6920 S EAST STREET
Address2: SUITE B
City: INDIANAPOLIS
State: IN
PostalCode: 462272215
CountryCode: US
TelephoneNumber: 3177811000
FaxNumber: 3177811051
Other Information
ProviderEnumerationDate: 05/30/2006
LastUpdateDate: 08/20/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X01062855AINY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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