Provider Demographics
NPI:1144242124
Name:VASILCHEK, DANICA M (MD)
Entity Type:Individual
Prefix:
First Name:DANICA
Middle Name:M
Last Name:VASILCHEK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:317-621-0868
Mailing Address - Fax:317-621-1110
Practice Address - Street 1:8150 OAKLANDON RD
Practice Address - Street 2:SUITE 130
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-9554
Practice Address - Country:US
Practice Address - Phone:317-621-1111
Practice Address - Fax:317-621-7110
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01050955A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000312791OtherANTHEM
IN214300CMedicare PIN
INM400037950Medicare PIN
P00099356Medicare PIN
IN000000312791OtherANTHEM