DAVE CURTIS PHONDO - NPI NUMBER 1942564786

Summary

Provider Name: DAVE CURTIS PHONDO

NPI Number: 1942564786

Clasification: Private Vehicle (347C00000X)

Address:
1805 REVERE PL
CARMEL, IN
ZIP 46032

Phone Number: (317) 853-6633



Detailed Information

Dave Curtis Phondo is a private vehicle in Carmel, IN. The provider is an individual paid to provide non-emergency transportation using their privately owned/leased vehicle. The assigned NPI number for this provider is 1942564786 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

1805 REVERE PL
CARMEL, IN
ZIP 46032-937
Phone: (317) 853-6633

The enumeration date for this NPI number is 6/26/2012 and was last updated on 6/26/2012.

Map - Location of Practice





Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 347C00000X Private Vehicle No
2 347C00000X Private Vehicle 347C00000X IN Yes

NPI Record

No. Field Name Field Value
1 NPI 1942564786
2 Entity Type Code 1
3 Provider Last Name Legal Name PHONDO
4 Provider First Name DAVE
5 Provider Middle Name CURTIS
6 Provider Name Suffix Text SR.
7 Provider First Line Business Practice Location Address 1805 REVERE PL
8 Provider Business Practice Location Address City Name CARMEL
9 Provider Business Practice Location Address State Name IN
10 Provider Business Practice Location Address Postal Code 460322937
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 3178536633
13 Provider Enumeration Date 6/26/2012
14 Last Update Date 6/26/2012
15 Provider Gender Code M
16 Healthcare Provider Taxonomy Code 1 347C00000X
17 Healthcare Provider Primary Taxonomy Switch 1 N
18 Healthcare Provider Taxonomy Code 2 347C00000X
19 Provider License Number 2 347C00000X
20 Provider License Number State Code 2 IN
21 Healthcare Provider Primary Taxonomy Switch 2 Y
22 Is Sole Proprietor Y

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This page was last updated on: 11/14/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.