Individual
ROBERT A DERSHEWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9660 WICKER AVENUE, 2ND FLOOR, ST JOHN, IN 46373-9487
(219) 226-2380
(219) 226-2381
Mailing address
9660 WICKER AVENUE, 2ND FLOOR, ST JOHN, IN 46373-9487
(219) 226-2380
(219) 226-2381
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01051751
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000081284
ANTHEM BCBS
IN
05
—
200254250A
—
IN
Enumeration date
08/03/2005
Last updated
06/17/2010
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