Individual
BENJAMIN PAUL ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
355 W 16TH ST STE 3200, INDIANAPOLIS, IN 46202-2280
(317) 963-7082
(317) 963-7085
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01076968A
IN
207Y00000X
Otolaryngology Physician
73698
GA
207Y00000X
Otolaryngology Physician
BP10037187
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201371010
—
IN
Enumeration date
08/09/2010
Last updated
01/25/2021
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