Individual
DR. FREDERICK ROBERT LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5255 E STOP 11 RD STE 250, INDIANAPOLIS, IN 46237-6343
(317) 528-2270
(317) 528-2286
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01037114A
IN
208C00000X
Colon & Rectal Surgery Physician
Primary
01037114
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100128830A
—
IN
Enumeration date
04/17/2006
Last updated
05/18/2023
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