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DOUGLAS J SCHWARTZENTRUBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
535 BARNHILL DR, RT 252, INDIANAPOLIS, IN 46202-5116
(317) 944-0301
(317) 278-6523
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
(317) 963-0860

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
01031937
IN
2086X0206X
Surgical Oncology Physician
Primary
01031937A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000720155
ANTHEM PIN
IN
05
200456350
IN
Enumeration date
01/19/2006
Last updated
07/09/2014
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