Individual
RICHARD CLEAVELIN PROBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 W DIVISION ST, SUITE 400 WEST, EVANSVILLE, IN 47710-1374
(812) 436-4501
(812) 436-4510
Mailing address
315 MULBERRY ST, EVANSVILLE, IN 47713-1252
(812) 421-7489
(812) 436-0209
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01036002
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000806881
ANTHEM BCBS
IN
05
—
100248000A
—
IN
01
—
200079040D
MEDICAID GROUP
IN
Enumeration date
04/04/2006
Last updated
01/06/2021
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