Provider Demographics
NPI:1255395794
Name:PINTO, AMAR G (MD)
Entity type:Individual
Prefix:
First Name:AMAR
Middle Name:G
Last Name:PINTO
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 1:550 S LANDMARK AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-3239
Mailing Address - Country:US
Mailing Address - Phone:812-333-5973
Mailing Address - Fax:812-330-3681
Practice Address - Street 1:550 LANDMARK AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403
Practice Address - Country:US
Practice Address - Phone:812-333-5973
Practice Address - Fax:812-330-3681
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT131144207RG0100X
IN01054106207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200526380Medicaid
IN264910GEMedicare PIN
IN200526380Medicaid
INI38825Medicare UPIN
INM400022195Medicare PIN