Provider Demographics
NPI:1649437922
Name:SZOTEK, PAUL P JR (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:P
Last Name:SZOTEK
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2937 GADSEN CIR S
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8393
Mailing Address - Country:US
Mailing Address - Phone:317-868-1305
Mailing Address - Fax:317-645-1477
Practice Address - Street 1:8435 CLEARVISTA PL STE 104
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3761
Practice Address - Country:US
Practice Address - Phone:317-868-1305
Practice Address - Fax:317-645-1477
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258212208600000X
IN01063653A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201073700Medicaid
INP01117675Medicare PIN
IN201073700Medicaid
INM400071261Medicare PIN
INM400075572Medicare PIN
INP01141622Medicare PIN
INM400065664Medicare PIN