Provider Demographics
NPI:1285125765
Name:PADILLA, MICHAEL G (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:G
Last Name:PADILLA
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:610 E SOUTHPORT RD STE 205
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-8592
Practice Address - Country:US
Practice Address - Phone:317-781-7370
Practice Address - Fax:317-782-8880
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2023-08-18
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Provider Licenses
StateLicense IDTaxonomies
IN02006294A207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine