Individual
LOUIS JOSEPH ANGELICCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8040 CLEARVISTA PKWY, SUITE 500, INDIANAPOLIS, IN 46256-5630
(317) 355-8326
(317) 621-4555
Mailing address
6626 E 75TH ST, 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01030336A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000764481
ANTHME
IN
05
—
200137580A
—
IN
01
—
P01134233
MEDICARE RAILROAD
IN
Enumeration date
09/09/2005
Last updated
12/16/2015
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