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Individual

ROBERT D DEITCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10300 N ILLINOIS ST, SUITE 1040, INDIANAPOLIS, IN 46290-1166
(317) 817-1765
(317) 817-1767
Mailing address
10300 N ILLINOIS ST, SUITE 1040, INDIANAPOLIS, IN 46290-1166
(317) 817-1765
(317) 817-1767

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01033749
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100068910C
IN
Enumeration date
03/23/2006
Last updated
01/08/2017
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