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Individual

AMY SUE GIFALDI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1373 E STATE ROAD 62, MADISON, IN 47250-7328
(812) 801-0840
(812) 801-0024
Mailing address
PO BOX 189, MADISON, IN 47250-0189
(812) 801-0840
(812) 801-0024

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01048639
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000042191
ANTHEM BCBS
01
020041434
MEDICARE RAILROAD
01
1087692
KENTUCKY PASSPORT MEDICAI
KY
05
200180740A
IN
01
2435771000
PASSPORT ADVANTAGE
KY
01
268222
BLACK LUNG
01
5745357
AETNA
05
64881477
KY
01
810895P
SIHO
Enumeration date
06/10/2006
Last updated
04/23/2015
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