Individual
WARREN K HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5901 TECHNOLOGY CENTER DRIVE, INDIANAPOLIS, IN 46278
(317) 328-4777
(317) 715-9965
Mailing address
5901 TECHNOLOGY CENTER DR, INDIANAPOLIS, IN 46278-6013
(317) 328-5050
(317) 328-5053
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01057537A
IN
2085R0202X
Diagnostic Radiology Physician
01057539
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000489398
ANTHEM PTAN
IN
05
—
200830130
—
IN
01
—
P00365330
RAILROAD PTAN
IN
Enumeration date
06/15/2006
Last updated
11/13/2024
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