Individual
DR. ROBERT E DIEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6372 GUILFORD AVE, INDIANAPOLIS, IN 46220-1750
(317) 255-3333
Mailing address
6372 GUILFORD AVE, INDIANAPOLIS, IN 46220-1750
(317) 255-3333
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003489A
IN
152W00000X
Optometrist
4901003625
MI
152WP0200X
Pediatric Optometrist
18003489A
IN
152WP0200X
Pediatric Optometrist
18003489B
IN
152WS0006X
Sports Vision Optometrist
18003489A
IN
Other
Enumeration date
12/18/2006
Last updated
11/04/2014
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