Individual
ROBERT STEPHEN AVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-3886
(317) 963-5492
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01080224A
IN
207P00000X
Emergency Medicine Physician
4301108244
MI
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
01080224A
IN
390200000X
Student in an Organized Health Care Education/Training Program
4301108244
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001168722
ANTHEM PTAN
IN
01
—
000001168723
ANTHEM PTAN
IN
01
—
000001368835
ANTHEM PTAN
IN
01
—
000001526585
ANTHEM PTAN
IN
05
—
300013384
—
IN
Enumeration date
06/19/2015
Last updated
02/26/2025
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