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Individual

ROBERT AVENA

Active
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Individual

ROBERT AVENA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
01038723A
IN
207R00000X
Internal Medicine Physician
Primary
01038723
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
023329800
FEDERAL BLACK LUNG
IN
05
1003265760C
IN
01
10780065
CAQH
IN
01
110123778
RAILROAD MEDICARE
IN
Enumeration date
08/02/2006
Last updated
08/11/2026
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