Provider Demographics
NPI:1851915441
Name:EMBALABALA, ALISON (MD)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:
Last Name:EMBALABALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 BARNHILL DR
Mailing Address - Street 2:EMERSON HALL 100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5112
Mailing Address - Country:US
Mailing Address - Phone:317-274-7105
Mailing Address - Fax:317-274-2940
Practice Address - Street 1:545 BARNHILL DR
Practice Address - Street 2:EMERSON HALL 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5112
Practice Address - Country:US
Practice Address - Phone:317-274-7105
Practice Address - Fax:317-274-2940
Is Sole Proprietor?:No
Enumeration Date:2020-05-30
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125075897208600000X
IN11024556A390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208600000XAllopathic & Osteopathic PhysiciansSurgery