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Individual

RICHARD C ZELLARS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
(317) 944-2524
Mailing address
250 N SHADELAND AVE, SUITE 130- PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
(410) 502-8000

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01075189A
IN
2085R0001X
Radiation Oncology Physician
D55742
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201286330
IN
05
845001300
MD
Enumeration date
06/25/2006
Last updated
03/23/2016
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