Provider Demographics
NPI:1477534402
Name:AUFIERO, THOMAS X (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:X
Last Name:AUFIERO
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 1:1116 N 16TH ST
Mailing Address - Street 2:STE A
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47904-2119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1176 N. 16TH STREET
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904
Practice Address - Country:US
Practice Address - Phone:765-448-8000
Practice Address - Fax:765-448-8085
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031632E208G00000X
IN01044191A208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA430447OtherBC & BS
IN200060400Medicaid
IN000000627232OtherANTHEM PROVIDER NUMBER
PA0012470490004Medicaid
IN815500V2Medicare PIN
INP00732737Medicare UPIN
IN200060400Medicaid
IN257700RMedicare PIN
IN000000627232OtherANTHEM PROVIDER NUMBER