Individual
NATE THEPJATRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8040 CLEARVISTA PARKWAY, SUITE 290, INDIANAPOLIS, IN 46256-5604
(317) 621-7780
(317) 621-7783
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01063790A
IN
2086X0206X
Surgical Oncology Physician
Primary
01063790A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000528259
ANTHEM
IN
01
—
000000609664
ANTHEM
IN
01
—
000000780870
ANTHEM
IN
05
—
200870520
—
IN
01
—
7695933
AETNA
IN
01
—
P01105845
MEDICARE RAILROAD
IN
Enumeration date
05/22/2007
Last updated
11/27/2023
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