Individual
DOUGLAS A BEREBITSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N SENATE AVE, INDIANAPOLIS, IN 46202-5306
(317) 567-2179
(317) 567-2191
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01055285
IN
207L00000X
Anesthesiology Physician
Primary
01055285A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001566064
ANTHEM PTAN
IN
01
—
1100090075
ANTHEM PTAN
IN
05
—
200428380
—
IN
01
—
Q00163136
RAILROAD PTAN
IN
Enumeration date
06/04/2006
Last updated
11/25/2024
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