Individual
REY PERCIVAL DUARTE VIVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 N RITTER AVE, SUITE 520, INDIANAPOLIS, IN 46219-3052
(317) 355-1234
(317) 355-1505
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01074619A
CA
207R00000X
Internal Medicine Physician
M7729
TX
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
01074619A
IN
207RC0000X
Cardiovascular Disease Physician
01074619A
CA
207RC0000X
Cardiovascular Disease Physician
01074619A
IN
207RC0000X
Cardiovascular Disease Physician
A110940
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188693904
—
TX
05
—
201254420
—
IN
01
—
8AH679
BLUE CROSS BLUE SHIELD
TX
01
—
P01424406
MEDICARE RAILROAD PTAN
IN
Enumeration date
07/30/2007
Last updated
06/14/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us