Individual
RYAN C. ROLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7956 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 435-6722
(260) 435-6726
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3514
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01057615
IN
208M00000X
Hospitalist Physician
Primary
01057615
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000490369
ANTHEM
IN
05
—
200445670
—
IN
05
—
2700349
—
OH
Enumeration date
09/15/2006
Last updated
09/29/2020
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