Provider Demographics
NPI:1598711905
Name:NANAGAS, VICTOR (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:NANAGAS
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 1:8101 CLEARVISTA PKWY
Mailing Address - Street 2:STE 185
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-4696
Mailing Address - Country:US
Mailing Address - Phone:317-621-9000
Mailing Address - Fax:317-621-9194
Practice Address - Street 1:8101 CLEARVISTA PKWY
Practice Address - Street 2:STE 185
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-4696
Practice Address - Country:US
Practice Address - Phone:317-621-9000
Practice Address - Fax:317-621-9194
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01051062A208000000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist