Provider Demographics
NPI:1679861702
Name:GAMARRA-HILBURN, CARLA FABIOLA (MD)
Entity type:Individual
Prefix:DR
First Name:CARLA
Middle Name:FABIOLA
Last Name:GAMARRA-HILBURN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 STATE ST STE 462
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-6801
Mailing Address - Country:US
Mailing Address - Phone:812-725-0200
Mailing Address - Fax:812-725-0190
Practice Address - Street 1:1919 STATE ST STE 462
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-6801
Practice Address - Country:US
Practice Address - Phone:812-725-0200
Practice Address - Fax:812-725-0190
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-13113207RR0500X
MA249445207R00000X
IN01076656A207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201361070Medicaid
AR1G0537OtherMEDICARE
ININ1189053OtherIN MEDICARE
AR247019001Medicaid
AR5EY59OtherBCBS OF AR