Individual
MARK RYAN KAUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 W MICHIGAN ST # CL630, INDIANAPOLIS, IN 46202-5209
(317) 278-2686
Mailing address
1120 W MICHIGAN ST # CL630, INDIANAPOLIS, IN 46202-5209
(317) 278-2686
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01083793A
IN
207RC0000X
Cardiovascular Disease Physician
01083793A
IN
207RI0011X
Interventional Cardiology Physician
01083793A
IN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
11019544A
IN
Other
Enumeration date
06/18/2017
Last updated
07/11/2025
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