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Individual

BENEDICTO L REYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9998 CROSSPOINT BLVD STE 200, INDIANAPOLIS, IN 46256-3307
(317) 579-2150
(317) 579-2130
Mailing address
9998 CROSSPOINT BLVD STE 200, INDIANAPOLIS, IN 46256-3307
(317) 579-2150
(317) 579-2130

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01043216A
IN
2085R0202X
Diagnostic Radiology Physician
1043216
IN
2085R0204X
Vascular & Interventional Radiology Physician
01043216A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000109943
ANTHEM
IN
05
200142070A
IN
01
300109485
RAILROAD MEDICARE
IN
01
822400W
MEDICARE PTAN
IN
01
P00018308
RR MEDICARE PIN
01
P00018311
RR MEDICARE PIN
01
P00018312
RR MEDICARE PIN
01
P00018313
RR MEDICARE PIN
01
P00018314
RR MEDICARE PIN
01
P00018395
RR MEDICARE PIN
01
P00018401
RR MEDICARE PIN
01
P00018580
RR MEDICARE PIN
01
P00018588
RR MEDICARE PIN
01
P00021420
RR MEDICARE PIN
01
P00023111
RR MEDICARE PIN
01
P00024405
RR MEDICARE PIN
Enumeration date
09/19/2005
Last updated
01/13/2021
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