Individual
MR. RODERICK NISI
Active
Individual
MR. RODERICK NISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01036283
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000085348
ANTHEM
IN
01
—
100009521
RAILROAD MEDICARE
IN
01
—
10004427
TCARE
IN
05
—
100176670
—
IN
05
—
100176670B
—
IN
05
—
64042377
—
KY
01
—
P01512511
MEDICARE RR
IN
Enumeration date
10/18/2006
Last updated
11/16/2016
Update your record
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