Individual
ROGER E BROCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7340 SHADELAND STA STE 200, INDIANAPOLIS, IN 46256-3980
(317) 806-8260
(317) 806-8296
Mailing address
7340 SHADELAND STA STE 200, INDIANAPOLIS, IN 46256-3980
(317) 579-2150
(317) 806-8296
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01032980
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0159584
—
OH
05
—
100329460A
—
IN
01
—
822400047
MEDICARE
IN
Enumeration date
07/20/2006
Last updated
12/11/2018
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