Individual
BOGUSLAW I UCHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 N MADISON AVE, ANDERSON, IN 46011-3453
(765) 298-5172
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01038206A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000089188
BLUE SHIELD
IN
05
—
100319500A
—
IN
Enumeration date
06/15/2005
Last updated
02/19/2021
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