Individual
JOHN H DITSLEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4922 E 161ST ST, NOBLESVILLE, IN 46062-9239
(317) 818-8981
Mailing address
4922 E 161ST ST, NOBLESVILLE, IN 46062-9239
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01045848A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000821044
ANTHEM
IN
01
—
020043808
RR MEDICARE TS
IN
05
—
200219370
—
IN
01
—
P00169887
RR MEDICARE CLARIAN
IN
01
—
P01275421
MEDICARE RR PTAN
IN
Enumeration date
06/20/2006
Last updated
03/31/2026
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