Provider Demographics
NPI:1699759753
Name:GIANARIS, PETER (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:GIANARIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8333 NAAB RD
Mailing Address - Street 2:STE 250
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5924
Mailing Address - Country:US
Mailing Address - Phone:317-396-1300
Mailing Address - Fax:317-396-1346
Practice Address - Street 1:355 W 16TH ST
Practice Address - Street 2:STE 5100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2207
Practice Address - Country:US
Practice Address - Phone:317-396-1300
Practice Address - Fax:317-924-8472
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2014-02-20
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Provider Licenses
StateLicense IDTaxonomies
IN01042982A207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100460530Medicaid
IN100460530Medicaid
IN4723080004Medicare NSC
IN4723080002Medicare NSC
IN061570AAMedicare ID - Type Unspecified