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Individual

DR. RODJAWAN SUPAKUL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
11700 N MERIDIAN ST, CARMEL, IN 46032-4656
(317) 962-5820
(317) 962-5841
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01088008A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
01088008A
IN
207RP1001X
Pulmonary Disease Physician
01088008A
IN
207RP1001X
Pulmonary Disease Physician
MD-43716
IA

Other

Enumeration date
10/07/2011
Last updated
03/12/2025
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