Individual
MITCHELL D KRATHWOHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 UNIVERSITY BLVD # UH3005, INDIANAPOLIS, IN 46202-5149
(317) 962-8851
(317) 962-5957
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01046293A
IN
207RI0200X
Infectious Disease Physician
Primary
01046293A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000377245
ANTHEM ID NUMBER
IN
01
—
000000720384
ANTHEM PROVIDER NUMBER FOR TIN 35-2030653
IN
05
—
200206000
—
IN
Enumeration date
02/21/2006
Last updated
12/07/2022
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