Provider Demographics
NPI:1558451740
Name:DEBROTA, DAVID JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:DEBROTA
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:LILLY CORPORATE CTR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46285-8363
Mailing Address - Country:US
Mailing Address - Phone:317-457-9960
Mailing Address - Fax:317-433-2815
Practice Address - Street 1:LILLY CORPORATE CTR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46285-0001
Practice Address - Country:US
Practice Address - Phone:317-276-3239
Practice Address - Fax:317-433-2815
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01033476A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine