Individual
ROBERTA A HIBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 W 10TH ST, B2100, INDIANAPOLIS, IN 46202-2859
(317) 630-7865
(317) 630-2587
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 274-1201
(317) 278-9905
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01034240
IN
2080C0008X
Child Abuse Pediatrics Physician
Primary
01034240
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100238580
—
IN
Enumeration date
08/25/2006
Last updated
01/13/2021
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