Provider Demographics
NPI:1891789103
Name:BLAHUNKA, JAMES J (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:BLAHUNKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9998 CROSSPOINT BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3307
Mailing Address - Country:US
Mailing Address - Phone:317-806-8260
Mailing Address - Fax:317-806-8296
Practice Address - Street 1:9998 CROSSPOINT BLVD
Practice Address - Street 2:STE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3307
Practice Address - Country:US
Practice Address - Phone:317-806-8260
Practice Address - Fax:317-806-8296
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01047869A2085R0202X, 2085R0202X
IN10478692085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300138598OtherRR MEDICARE PINS
INP00024088OtherRR MEDICARE PINS
IN00000189547OtherANTHEM
INP00024186OtherRR MEDICARE PINS
IN200279170AMedicaid
INP00024063OtherRR MEDICARE PINS
INP00024093OtherRR MEDICARE PINS
INP00024074OtherRR MEDICARE PINS
INP00024075OtherRR MEDICARE PINS
INP00024190OtherRR MEDICARE PINS
INP00361003OtherRR MEDICARE PINS
INP00024110OtherRR MEDICARE PINS
INP00024187OtherRR MEDICARE PINS
INP00024420OtherRR MEDICARE PINS
IN300122034OtherRAILROAD MEDICARE
INP00024108OtherRR MEDICARE PINS
IN222750BBMedicare PIN
INP00024190OtherRR MEDICARE PINS
INP00024187OtherRR MEDICARE PINS
INP00024075OtherRR MEDICARE PINS
INP00024186OtherRR MEDICARE PINS