Individual
RUDOLPH ROUHANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 N POST RD, SUITE 2, INDIANAPOLIS, IN 46219-4225
(317) 355-6780
(317) 355-6782
Mailing address
6626 E. 75TH STREET, SUITE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01026170A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000313002
ANTHEM
IN
05
—
100057800
—
IN
Enumeration date
07/30/2006
Last updated
03/09/2015
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