Individual
RYAN GENE HATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 639-6671
(317) 963-5492
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01090494A
IN
207P00000X
Emergency Medicine Physician
2008-01729
NC
207P00000X
Emergency Medicine Physician
46186
TN
207P00000X
Emergency Medicine Physician
47146
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1100204183
ANTHEM PTAN
IN
05
—
1519461
—
TN
05
—
201248630
—
IN
05
—
5911009
—
NC
Enumeration date
12/07/2007
Last updated
03/25/2025
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