Provider Demographics
NPI:1093014680
Name:GAD FLAUMENHAFT PC
Entity Type:Organization
Organization Name:GAD FLAUMENHAFT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GAD
Authorized Official - Middle Name:
Authorized Official - Last Name:FLAUMENHAFT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:317-776-0077
Mailing Address - Street 1:475 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-1315
Mailing Address - Country:US
Mailing Address - Phone:317-776-0077
Mailing Address - Fax:317-776-0085
Practice Address - Street 1:475 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1315
Practice Address - Country:US
Practice Address - Phone:317-776-0077
Practice Address - Fax:317-776-0085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000411213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100125660AMedicaid
IN100125660AMedicaid