Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 01061813A | IN |
NPI | 1063551240 |
---|---|
Provider Name | Pablo M Bedano |
First Address | Indianapolis, IN 46250-2890 |
Second Address | Indianapolis, IN 46250-2042 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 28/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000514117 | ANTHEM (01) | IN |
200852150 | (05) | IN |
404180 | WELLCARE (01) | IN |
7583881 | AETNA (01) | IN |
8136417 | CIGNA (01) | IN |
I73082 | (02) | IN |
P00464789 | MEDICARE RR (01) | IN |
P00759319 | MEDICARE RR (01) | IN |
P01751203 | RR MEDICARE (01) | IN |