Provider Demographics
NPI:1326043282
Name:GERMAN, NARCISA CODRUTA (MD)
Entity Type:Individual
Prefix:
First Name:NARCISA
Middle Name:CODRUTA
Last Name:GERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NARCISA
Other - Middle Name:CODRUTA
Other - Last Name:BENEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:550 S LANDMARK AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-3239
Mailing Address - Country:US
Mailing Address - Phone:812-355-6582
Mailing Address - Fax:812-355-2319
Practice Address - Street 1:2605 E CREEKS EDGE DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-8368
Practice Address - Country:US
Practice Address - Phone:812-355-6582
Practice Address - Fax:812-355-2319
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01060727A207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200184670Medicaid
INM400021732Medicare PIN
INM400021732Medicare PIN