Individual
HIDEKI KAWANISHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
515 S WOODSCREST DR, BLOOMINGTON, IN 47401-5524
(812) 333-8194
(812) 333-8237
Mailing address
515 S WOODSCREST DR, BLOOMINGTON, IN 47401-5524
(812) 333-8194
(812) 333-8237
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01059330A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000368280
ANTHEM
IN
05
—
200502110
—
IN
Enumeration date
08/19/2006
Last updated
04/18/2025
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