Individual
JOSHUA DAWALT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7439 WOODLAND DR, STE 105, INDIANAPOLIS, IN 46278-1765
(317) 644-5100
(317) 644-5101
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
(317) 621-9312
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02002880A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000715195
ANTHEM
IN
05
—
201018480
—
IN
01
—
P01347694
RAIL ROAD MEDICARE
IN
Enumeration date
07/17/2006
Last updated
11/27/2023
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