Individual
MATT A RUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD, RM DG412, INDIANAPOLIS, IN 46202-1239
(317) 962-3886
(317) 962-5492
Mailing address
250 N SHADELAND AVE, SUITE 130, INDIANAPOLIS, IN 46219-4959
(317) 963-0860
(317) 962-4343
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01072888A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000836126
ANTHEM PIN
IN
05
—
201171920
—
IN
Enumeration date
05/14/2012
Last updated
03/06/2025
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