Individual
RYAN DAVID BOENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 UNIVERSITY BLVD STE 230, INDIANAPOLIS, IN 46202-5149
(317) 944-5000
(317) 944-4224
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01078956A
IN
207R00000X
Internal Medicine Physician
57-
OH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
01078956A
IN
207RP1001X
Pulmonary Disease Physician
01078956A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001186097
ANTHEM PTAN
IN
01
—
000001191723
ANTHEM PTAN
IN
05
—
300001940
—
IN
Enumeration date
07/01/2011
Last updated
03/04/2025
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