Individual
DAVID RYUSUKE OKANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1130 WEST MICHIGAN STREET, FESLER HALL RM 204, INDIANAPOLIS, IN 46202-5135
(317) 274-0275
(317) 274-0256
Mailing address
1120 SOUTH DR, FESLER HALL, RM. 204, INDIANAPOLIS, IN 46202-5135
(317) 274-0269
(317) 274-0256
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01063992A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000567891
ANTHEM-ANESTHESIA
IN
01
—
000000576095
ANTHEM-PAIN
IN
05
—
200905390
—
IN
Enumeration date
10/24/2007
Last updated
02/17/2020
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