Individual
JAMES W, EHLICH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5255 E STOP 11 RD STE 320, INDIANAPOLIS, IN 46237-6341
(317) 888-1467
(317) 888-1476
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01036561A
IN
207RR0500X
Rheumatology Physician
Primary
01036561A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000538180
ANTHEM
IN
05
—
100332180
—
IN
Enumeration date
11/18/2005
Last updated
06/05/2023
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