Provider Demographics
NPI:1669413043
Name:BANGALORE, NALINI A (MD)
Entity type:Individual
Prefix:DR
First Name:NALINI
Middle Name:A
Last Name:BANGALORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BANGALORE
Other - Middle Name:A
Other - Last Name:NALINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8535 N CLEARVIEW DR
Mailing Address - Street 2:STE 400
Mailing Address - City:MCCORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-6240
Mailing Address - Country:US
Mailing Address - Phone:317-335-6930
Mailing Address - Fax:317-335-5030
Practice Address - Street 1:8535 N CLEARVIEW DR
Practice Address - Street 2:STE 400
Practice Address - City:MCCORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46055-6240
Practice Address - Country:US
Practice Address - Phone:317-335-6930
Practice Address - Fax:317-335-5030
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01054007207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200323670Medicaid
IN676070KMedicare PIN
IN200323670Medicaid