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Individual

ROBERT E SHOEMAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8075 N SHADELAND AVE, SUITE 200, INDIANAPOLIS, IN 46250-2693
(317) 621-8500
(317) 621-8501
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01026362A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000569473
ANTHEM
IN
05
100366890
IN
01
399832
WELLCARE
IN
01
4004424
AETNA
IN
01
P01198087
RR MEDICARE PTAN
IN
Enumeration date
08/18/2005
Last updated
12/05/2014
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