Individual
MARY RHODES ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7250 CLEARVISTA DR STE 355, INDIANAPOLIS, IN 46256-5609
(317) 621-5676
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002339A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300007634
—
IN
Enumeration date
08/31/2017
Last updated
11/23/2021
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