Individual
TRESA V RATTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2051 CLEVIDENCE BLVD STE C, CLARKSVILLE, IN 47129-2278
(812) 280-6623
(812) 666-7688
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01038674A
IN
208000000X
Pediatrics Physician
25265
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000065707
ANTHEM / NCMA
KY
01
—
000023031A
HUMANA / NCMA
KY
01
—
009023
SIHO / NCMA
KY
05
—
100344080
—
IN
01
—
1194546
CHA / NCMA
KY
01
—
2528638-002
CIGNA / NCMA
KY
05
—
64252653
—
KY
Enumeration date
04/19/2006
Last updated
04/12/2024
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