Individual
ROBERT LAREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904-2479
(765) 448-8000
(765) 448-7072
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01033786A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000189789
ANTHEM PROVIDER NUMBER
IN
05
—
100087530
—
IN
01
—
10825452
CAQH NUMBER
IN
01
—
9397218
PHCS PID NUMBER
IN
05
—
LA15637018
—
IN
Enumeration date
03/16/2006
Last updated
01/22/2021
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