Provider Demographics
NPI:1043214034
Name:POER, DAVID V (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:V
Last Name:POER
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8902 N MERIDIAN ST
Mailing Address - Street 2:STE 120
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5306
Mailing Address - Country:US
Mailing Address - Phone:317-582-1118
Mailing Address - Fax:317-582-1116
Practice Address - Street 1:8902 N MERIDIAN ST
Practice Address - Street 2:STE 120
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5306
Practice Address - Country:US
Practice Address - Phone:317-582-1118
Practice Address - Fax:317-582-1116
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01025779207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000085332OtherANTHEM PIN
IN100071570Medicaid
IN180001035OtherRAILROAD MEDICARE
INB28395Medicare UPIN
IN267120AMedicare ID - Type Unspecified
IN263670EMedicare PIN