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Contact Information

GREGORY W BOAKE, DPM
10122 E 10TH ST STE 230
INDIANAPOLIS, IN46229-2664
 Phone: 317-355-7356
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for GREGORY W BOAKE · (Male)

NPI Number 1235143512
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 07/29/2006
Last updated 02/09/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 070001028A
  • IN Medicaid 20087023
  • Other 5324290005 DME AC
  • Other 5324290004 DME BR
  • Other 5324290003 DME ES
  • Other 5324290008 DME FC
  • Other 5324290006 DME MC
  • Other 5324290007 DME WV
  • IN Other 070001028A PODIATRIST LICENSE
Hospital affiliation(s)
  • COMMUNITY HOSPITAL EAST - (Acute Care)
    1500 N RITTER AVE
    INDIANAPOLIS, IN 46219
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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