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Individual

DR. ROBERT TODD RUDICEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8890 E 116TH ST, SUITE 260, FISHERS, IN 46038-2856
(317) 621-8953
(317) 621-4456
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01050364A
IN
208000000X
Pediatrics Physician
01050364B
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000092060
ANTHEM HEALTH PLAN
IN
05
201103750
IN
01
7771014
AETNA HEALTH PLAN
IN
01
8349601001
CIGNA HEALTHCARE
IN
01
P01588241
RR MEDICARE
IN
Enumeration date
11/03/2005
Last updated
11/27/2023
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