Individual
BENJAMIN K NTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 944-5000
(317) 963-5492
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
46874
KY
208000000X
Pediatrics Physician
Primary
01072038A
IN
208000000X
Pediatrics Physician
46874
KY
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
01072038A
IN
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
46874
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001087478
ANTHEM PTAN
IN
01
—
000001432804
ANTHEM PTAN
IN
01
—
000001461298
ANTHEM PTAN
IN
05
—
201100850
—
IN
05
—
7100321280
—
KY
Enumeration date
06/09/2009
Last updated
03/05/2025
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