Provider Demographics
NPI:1629237078
Name:KHADILKAR, NITIN ARUN (MD)
Entity Type:Individual
Prefix:DR
First Name:NITIN
Middle Name:ARUN
Last Name:KHADILKAR
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:PO BOX 1230
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1230
Mailing Address - Country:US
Mailing Address - Phone:812-476-7200
Mailing Address - Fax:812-471-4514
Practice Address - Street 1:7200 E INDIANA ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-2753
Practice Address - Country:US
Practice Address - Phone:812-476-7200
Practice Address - Fax:812-471-4514
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01067603A2084P0800X
VA01160181002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200983820Medicaid
INM400025604Medicare PIN
IN200983820Medicaid