MEDICARE: MARIA C RANOLA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	01064380A	IN
2	208M00000X	Hospitalist Physician	01064380A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000549002	OTHER	IN	ANTHEM PIN - GATEWAY BLVD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194703959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA C RANOLA MD

Provider Business Mailing Address
First Line	:	PO BOX 3407
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47733-3407
Country	:	US
Telephone Number	:	812-450-6815
Fax Number	:	812-450-6822

Provider Business Practice Location Address
First Line	:	4011 GATEWAY BLVD
Second Line	:
City	:	NEWBURGH
State	:	IN
Zip	:	47630-8947
Country	:	US
Telephone Number	:	812-450-6815
Fax Number	:	812-450-6822

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	04/13/2015

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Directions to “ MARIA C RANOLA MD” Practice Location

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