Individual
MATVEY V BOBYLEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5165 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 448-8000
(765) 448-7651
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01084022A
IN
207L00000X
Anesthesiology Physician
35080863
OH
207LP2900X
Pain Medicine (Anesthesiology) Physician
01084022A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2675949
—
OH
Enumeration date
08/05/2006
Last updated
03/23/2023
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