Provider Demographics
NPI:1710092663
Name:DASGUPTA, NOEL R (MD)
Entity Type:Individual
Prefix:DR
First Name:NOEL
Middle Name:R
Last Name:DASGUPTA
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 1:7301 SOLUTION CTR
Mailing Address - Street 2:LOCKBOX 777301
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-7003
Mailing Address - Country:US
Mailing Address - Phone:877-668-5621
Mailing Address - Fax:317-962-5580
Practice Address - Street 1:1801 N SENATE BLVD
Practice Address - Street 2:STE. 4000
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1228
Practice Address - Country:US
Practice Address - Phone:317-962-0500
Practice Address - Fax:317-962-0574
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME107152207RC0000X
IN01069686A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00968975OtherRAILROAD MEDICARE
INP01157835OtherRAILROAD MEDICARE
IN000000725356OtherANTHEM
IN201021760Medicaid
INM400047400Medicare PIN
IN201021760Medicaid