Provider Demographics
NPI:1043279615
Name:VULANICH, ELIZABETH A (DPM)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:A
Last Name:VULANICH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5471 GEORGETOWN RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-5793
Mailing Address - Country:US
Mailing Address - Phone:317-297-0661
Mailing Address - Fax:
Practice Address - Street 1:2230 STAFFORD RD STE 145
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-2793
Practice Address - Country:US
Practice Address - Phone:317-856-8866
Practice Address - Fax:317-856-2312
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000843A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200220630AMedicaid
IN480027012Medicare PIN
INU02726Medicare UPIN
IN200220630AMedicaid
IN0812540001Medicare NSC