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Individual

MICHAEL T ROUTSONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3925 ALEX CT, LAFAYETTE, IN 47905-7746
(765) 200-2014
Mailing address
3925 ALEX CT, LAFAYETTE, IN 47905-7746

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01060091A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000361518
ANTHEM
IN
01
000000378091
ANTHEM
IN
05
200314540
IN
Enumeration date
06/14/2006
Last updated
09/17/2014
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