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Individual

MR. MICHAEL RAY RALPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AUDIOLOGIST MS CCCA

Contact information

Practice address
2320 S TIBBS AVENUE, STE A, INDIANAPOLIS, IN 46241-4801
(317) 486-1936
(317) 486-1937
Mailing address
2320 S TIBBS AVENUE, STE A, INDIANAPOLIS, IN 46241-4801
(317) 486-1936
(317) 486-1937

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23001921
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000093067
ANTHEM BLUE CROSS
IN
01
000000201103
ANTHEM BLUE CROSS
IN
01
AN15840270001
CIGNA
IN
Enumeration date
09/07/2006
Last updated
07/08/2007
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