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Individual

DR. NEIL BARROS MASCARENHAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2403 LOY DR, LAFAYETTE, IN 47909-2701
(765) 448-8000
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
125052248
IL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
01070998A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000767924
ANTHEM PROVIDER NUMBER
IN
05
201066920
IN
Enumeration date
08/04/2008
Last updated
01/27/2021
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