Individual
RUTA GANDHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
621 MEMORIAL DR, SUITE 403, SOUTH BEND, IN 46601-1063
(574) 232-4800
Mailing address
PO BOX 1916, SOUTH BEND, IN 46634-1916
Taxonomy
Speciality
Code
Description
License number
State
207YX0602X
Otolaryngic Allergy Physician
Primary
01038895
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000085506
ANTHEM PIN
IN
01
—
01038895
LICENSE
IN
05
—
100351720A
—
IN
Enumeration date
06/30/2006
Last updated
03/07/2023
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