Individual
ROBERT E CLEMENTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10935 RIDGE COURT, INDIANAPOLIS, IN 46256-9674
(317) 849-6924
(217) 849-2413
Mailing address
10935 RIDGE COURT, INDIANAPOLIS, IN 46256-9674
(317) 849-6924
(217) 849-2413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01025322
IN
207Q00000X
Family Medicine Physician
01025322A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000312979
ANTHEM
IN
05
—
100127490
—
IN
01
—
P00072546
RR MEDICARE
IN
Enumeration date
07/25/2006
Last updated
07/01/2019
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