Individual
RONALD MASTOURI
Active
Individual
RONALD MASTOURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01067326A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11012317A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000109684
ANTHEM PTAN
IN
01
—
000000663387
ANTHEM PTAN
IN
01
—
000001132526
ANTHEM PTAN
IN
05
—
200982540
—
IN
01
—
P00910464
RAILROAD MEDICARE
IN
Enumeration date
06/16/2008
Last updated
03/14/2025
Update your record
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