Provider Demographics
NPI:1629062930
Name:BELOW, MARY E (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:BELOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9998 CROSSPOINT BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3307
Mailing Address - Country:US
Mailing Address - Phone:317-579-2150
Mailing Address - Fax:317-579-2130
Practice Address - Street 1:9998 CROSSPOINT BLVD STE 200
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3307
Practice Address - Country:US
Practice Address - Phone:317-579-2150
Practice Address - Fax:317-579-2130
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039339A2085R0202X, 2085R0204X
IN10393392085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000109951OtherANTHEM
IN100348820AMedicaid
IN822400QMedicare PIN
IN100348820AMedicaid
INP00024045OtherRR MEDICARE PINS
INP00023103OtherRR MEDICARE PINS
IN222750AAMedicare PIN
IN152410AAMedicare PIN
IN151720WMedicare PIN
INP00023395OtherRR MEDICARE PINS
INP00024053OtherRR MEDICARE PINS
INP00023643OtherRR MEDICARE PINS
INP00024043OtherRR MEDICARE PINS
INF73805Medicare UPIN
INP00024051OtherRR MEDICARE PINS
INP00024113OtherRR MEDICARE PINS
INP00024044OtherRR MEDICARE PINS
IN822400QMedicare PIN
IN151560ZMedicare PIN
INP00024103OtherRR MEDICARE PINS
IN100348820AMedicaid