Provider Demographics
NPI:1457308801
Name:PARZIALE, VINCENT S (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:S
Last Name:PARZIALE
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 1:6626 E. 75TH STREET
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:317-497-1920
Mailing Address - Fax:317-497-1919
Practice Address - Street 1:6920 S EAST STREET
Practice Address - Street 2:SUITE B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-2215
Practice Address - Country:US
Practice Address - Phone:317-781-1000
Practice Address - Fax:317-781-1051
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01062855A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B85139Medicare UPIN
INP00620698Medicare PIN
INM400036336Medicare PIN
IN214520CMedicare PIN