Provider Demographics
NPI:1194130609
Name:GEMPESAW, FEDERICO JESUS (DC)
Entity type:Individual
Prefix:DR
First Name:FEDERICO
Middle Name:JESUS
Last Name:GEMPESAW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 MEDICAL DR
Mailing Address - Street 2:#4322
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46082-0488
Mailing Address - Country:US
Mailing Address - Phone:317-436-7318
Mailing Address - Fax:
Practice Address - Street 1:10412 ALLISONVILLE RD
Practice Address - Street 2:203
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2052
Practice Address - Country:US
Practice Address - Phone:317-436-7318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002737A111N00000X
CADC24376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor