Endocrinology Diabetes and Obesity Clinic

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

ENDOCRINOLOGY DIABETES AND OBESITY CLINIC

Practice address

11805 N Pennsylvania St
Carmel, IN 46032-4555

Phone

(317) 706-6733

Fax

(317) 706-6723

NPI assigned

Oct 14, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Demetrios T Herodotu, MD

Title

President

Phone

(317) 706-6733

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287014400000",
    "number": "1609186402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11805 N PENNSYLVANIA ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460324555",
            "telephone_number": "317-706-6733",
            "fax_number": "317-706-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11805 N PENNSYLVANIA ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460324555",
            "telephone_number": "317-706-6733",
            "fax_number": "317-706-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOCRINOLOGY DIABETES AND OBESITY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-14",
        "last_updated": "2010-10-14",
        "status": "A",
        "authorized_official_last_name": "HERODOTU",
        "authorized_official_first_name": "DEMETRIOS",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-706-6733",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.