Individual
WILLIAM A BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N SENATE AVE, ROOM 1204A, INDIANAPOLIS, IN 46202-5306
(317) 962-6793
(317) 962-8281
Mailing address
714 N SENATE AVE, STE EF100, INDIANAPOLIS, IN 46202-3763
(317) 715-6402
(317) 715-6415
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
01049194A
IN
2085R0202X
Diagnostic Radiology Physician
01049194
IN
2085R0202X
Diagnostic Radiology Physician
Primary
01049194A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000244247
ANTHEM PTAN
IN
05
—
200188580
—
IN
Enumeration date
06/12/2006
Last updated
11/14/2024
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