Provider Demographics
NPI:1982615852
Name:VALCARCEL, JOEL JOSE C (MD)
Entity type:Individual
Prefix:
First Name:JOEL JOSE
Middle Name:C
Last Name:VALCARCEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOEL
Other - Middle Name:
Other - Last Name:CAPUPUS
Other - Suffix:
Other - Last Name Type:Other Name
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 1:10101 ERNST RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:IN
Practice Address - Zip Code:46783-9712
Practice Address - Country:US
Practice Address - Phone:260-234-5400
Practice Address - Fax:260-234-5410
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11012536207Q00000X
IN01064457A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000647243OtherANTHEM
IN200900240Medicaid
IN000000647211OtherANTHEM
IN000000647243OtherANTHEM
IN069860F1Medicare PIN