Provider Demographics
NPI:1861495533
Name:OSTROWSKI, VINCENT BENEDICT (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:BENEDICT
Last Name:OSTROWSKI
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 1:7440 N SHADELAND AVE
Mailing Address - Street 2:STE 150
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2095
Mailing Address - Country:US
Mailing Address - Phone:317-842-4901
Mailing Address - Fax:317-842-4393
Practice Address - Street 1:7440 N SHADELAND AVE
Practice Address - Street 2:STE 150
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2095
Practice Address - Country:US
Practice Address - Phone:317-842-4901
Practice Address - Fax:317-842-4393
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056562A207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN4858133OtherCIGNA PROVIDER NUMBER
IN000000279382OtherANTHEM PROVIDER NUMBER
IN78003961OtherAETNA PROVIDER NUMBER
IN248004OtherHEALTHLINK PROVIDER NUMBE
IN248004OtherHEALTHLINK PROVIDER NUMBE
IN199540BMedicare ID - Type Unspecified