Individual
BENJAMIN PAOLO M ABRATIGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1402 E COUNTY LINE RD, INDIANAPOLIS, IN 46227
(317) 887-7000
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02004522A
IN
207Q00000X
Family Medicine Physician
11016709A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201071000
—
IN
01
—
P01588206
RR MEDICARE
IN
Enumeration date
06/18/2012
Last updated
06/04/2021
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