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Individual

RONALD S BORIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11725 N ILLINOIS ST, SUITE 558, CARMEL, IN 46032-3008
(317) 688-5500
(317) 688-5511
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01068316A
IN
208800000X
Urology Physician
430108005
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000673864
ANTHEM PIN
IN
05
200990140
IN
Enumeration date
06/22/2007
Last updated
05/16/2025
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