Individual
BENJAMIN M WHITTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 RILEY HOSPITAL DRIVE, STE 4230, INDIANAPOLIS, IN 46202
(317) 944-8896
(317) 274-7481
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
01069666A
IN
2088P0231X
Pediatric Urology Physician
Primary
01069666A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000765563
ANTHEM PIN
IN
05
—
201052820
—
IN
Enumeration date
01/04/2007
Last updated
03/15/2025
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