Individual
MELANY S ROOKSTOOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8040 CLEARVISTA PKWY, INDIANAPOLIS, IN 46256-5630
(317) 614-9641
(317) 614-9655
Mailing address
PO BOX 6005, DEPT 196, INDIANAPOLIS, IN 46206-6005
(317) 567-2180
(800) 731-0751
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01040513
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000711855
ANTHEM
IN
05
—
200056520
—
IN
01
—
P00936233
RRMEDICARE
IN
Enumeration date
04/11/2006
Last updated
08/05/2011
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