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Individual

RANDALL T LODER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 274-2500
Mailing address
250 N SHADELAND AVENUE, SUITE 130, INDIANAPOLIS, IN 46219-4959
(317) 963-0860

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01056971A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200427130
IN
Enumeration date
05/12/2006
Last updated
05/08/2015
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