Individual
PARIS ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
541 CLINICAL DRIVE, CL 365, INDIANAPOLIS, IN 46202-5111
(317) 274-0550
(317) 274-4311
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
01037016A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200328550
—
IN
Enumeration date
04/17/2006
Last updated
03/05/2025
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