Provider Demographics
NPI:1568696615
Name:GINDE, SAMIR RAVINDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:RAVINDRA
Last Name:GINDE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1100 SOUTHFIELD DRIVE
Mailing Address - Street 2:SUITE 1370
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-4300
Mailing Address - Country:US
Mailing Address - Phone:317-837-5571
Mailing Address - Fax:317-837-5580
Practice Address - Street 1:1000 E MAIN STREET
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1948
Practice Address - Country:US
Practice Address - Phone:317-718-4741
Practice Address - Fax:317-718-6740
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2021-04-01
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Provider Licenses
StateLicense IDTaxonomies
IN01071159A208M00000X
IN11014930A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201096960Medicaid
IN354590003Medicare PIN