Provider Demographics
NPI:1861575342
Name:CZARKOWSKI, ROBERT ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALAN
Last Name:CZARKOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:ALAN
Other - Last Name:CZARKOWSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:13400 N MERIDIAN STREET
Mailing Address - Street 2:SUITE 600
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-7107
Mailing Address - Country:US
Mailing Address - Phone:317-582-7529
Mailing Address - Fax:317-582-7602
Practice Address - Street 1:13400 N MERIDIAN STREET
Practice Address - Street 2:SUITE 600
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-7107
Practice Address - Country:US
Practice Address - Phone:317-582-7529
Practice Address - Fax:317-582-7602
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01034102A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100126390AMedicaid
B28767Medicare UPIN
IN313510Medicare ID - Type Unspecified