Individual
MARK C ESTRADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
75 N STATE ROAD 135, GREENWOOD, IN 46142-1456
(317) 962-6793
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
01044930
IN
2085R0202X
Diagnostic Radiology Physician
01044930
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200186830
—
IN
01
—
P00176826
RAILROAD MEDICARE
IN
Enumeration date
06/13/2006
Last updated
03/16/2021
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