Individual
DONALD D COREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1701 N SENATE BLVD, ROOM 1204A, INDIANAPOLIS, IN 46202-1239
(317) 962-6793
(317) 962-8281
Mailing address
250 N SHADELAND AVE, SUITE 130, INDIANAPOLIS, IN 46219-4959
(317) 963-0860
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
02002342A
IN
2085R0202X
Diagnostic Radiology Physician
02002342
IN
2085U0001X
Diagnostic Ultrasound Physician
Primary
02002342A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200322430
—
IN
01
—
P00043584
RAILROAD MEDICARE
IN
Enumeration date
06/04/2006
Last updated
02/04/2021
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