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Individual

RALPH J MARSALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
9650 E WASHINGTON ST, STE 100, INDIANAPOLIS, IN 46229-3032
(317) 890-5500
(317) 890-5566
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000047A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00924299
RAILROAD MEDICARE PTAN
IN
Enumeration date
06/23/2006
Last updated
02/26/2014
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