Individual
DR. ARNOLD ROBLES REQUIERME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2600 FERRY ST, LAFAYETTE, IN 47904-3055
(765) 448-8000
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
(765) 448-8085
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01062619A
IN
208M00000X
Hospitalist Physician
Primary
01062619A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000497330
ANTHEM
IN
01
—
000000646062
ANTHEM PROVIDER NUMBER
IN
05
—
200839820
—
IN
Enumeration date
10/04/2006
Last updated
06/29/2010
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