Individual
YATISH SIDDAPURA RANGANATH
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) 274-0275
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01085767A
IN
207L00000X
Anesthesiology Physician
40002
IA
207L00000X
Anesthesiology Physician
69640
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001586909
ANTHEM PTAN
IN
05
—
300050800
—
IN
Enumeration date
04/26/2012
Last updated
12/02/2024
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