Provider Demographics
NPI:1366444226
Name:HARVEY, WILLIAM L F (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:L F
Last Name:HARVEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:STE 130 - PROVIDER ENROLLMENT
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11725 N ILLINOIS STREET
Practice Address - Street 2:SUITE 465
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3010
Practice Address - Country:US
Practice Address - Phone:317-688-5840
Practice Address - Fax:317-688-5841
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01044608A207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200152990Medicaid
INP00845900OtherRAILROAD MEDICARE
ING59042Medicare UPIN
IN200152990Medicaid
INP00845900OtherRAILROAD MEDICARE
INM400015666Medicare PIN