Provider Demographics
NPI:1083657613
Name:FRANCOMANO, CLAIR A (MD)
Entity type:Individual
Prefix:
First Name:CLAIR
Middle Name:A
Last Name:FRANCOMANO
Suffix:
Gender:
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 1:1002 WISHARD BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-4163
Practice Address - Country:US
Practice Address - Phone:317-944-3966
Practice Address - Fax:317-968-1354
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD25334207R00000X
MDD025334207SG0201X, 207SG0203X
IN01082750A207SG0201X, 207SG0203X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300029364Medicaid
MD381451300Medicaid
IN000001304926OtherANTHEM PTAN
MD712L/188785YBPGMedicare PIN
MDP00346702Medicare PIN
MDP00346705Medicare PIN
MD381451300Medicaid
MD700LM339Medicare PIN