Provider Demographics
NPI:1942268172
Name:MACHADO, ROBERTO F (MD)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:F
Last Name:MACHADO
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 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1801 N. SENATE BLVD
Practice Address - Street 2:SUITE 2000
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-962-9700
Practice Address - Fax:317-962-9657
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036121915207RC0200X
MDD0061103207RC0200X, 207RP1001X
IN01079162A207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD405250100Medicaid
DC035812800Medicaid
DC035812800Medicaid
MD014477I28Medicare ID - Type Unspecified