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Individual

RICHARD JAMES BASTIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-1772
Mailing address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-1772

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01056584A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200439150
IN
Enumeration date
02/14/2006
Last updated
04/21/2016
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