Individual
DR. RAFAEL JOSE ROLON RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-8776
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01079857A
IN
207R00000X
Internal Medicine Physician
18717
PR
207R00000X
Internal Medicine Physician
49217
AZ
207R00000X
Internal Medicine Physician
54192
TN
208M00000X
Hospitalist Physician
49127
AZ
208M00000X
Hospitalist Physician
ME130170
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020020500
—
FL
01
—
068010839
MEDICARE PTAN
IN
Enumeration date
06/24/2011
Last updated
10/05/2023
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