Individual
DR. ROBERT M. SIWIEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11725 ILLINOIS ST STE 275, CARMEL, IN 46032-3009
(317) 944-0980
(317) 968-1348
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036122288
IL
207RG0100X
Gastroenterology Physician
Primary
01070921A
IN
207RG0100X
Gastroenterology Physician
5272620
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000775536
ANTHEM
IN
05
—
201059780
—
IN
01
—
P01163479
RAILROAD MEDICARE
IN
Enumeration date
08/04/2008
Last updated
03/11/2025
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