Provider Demographics
NPI:1821099946
Name:BURWINKEL, RONALD P (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:P
Last Name:BURWINKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:950 N MERIDIAN ST
Mailing Address - Street 2:STE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-3908
Mailing Address - Country:US
Mailing Address - Phone:317-962-4942
Mailing Address - Fax:317-962-4950
Practice Address - Street 1:11725 ILLINOIS STREET
Practice Address - Street 2:SUITE 465
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3010
Practice Address - Country:US
Practice Address - Phone:317-817-0010
Practice Address - Fax:317-817-0012
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01051393A207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6402228800Medicaid
IN200233100Medicaid
INP00845898OtherRAILROAD MEDICARE
IN290011863Medicare PIN
INP00845898OtherRAILROAD MEDICARE
IN267030XXXMedicare PIN
IN165460GMedicare PIN