Individual
ROMA GAUTAM PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
1701 N SENATE BLVD, ROOM AG012, INDIANAPOLIS, IN 46202-1239
(317) 962-5975
Mailing address
250 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
11018750A
IN
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
01079200A
IN
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
01079200A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001462232
ANTHEM PTAN
IN
Enumeration date
05/31/2016
Last updated
03/15/2025
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