Healthcare Provider Details

I. General information

NPI: 1437160181
Provider Name (Legal Business Name): ROBERT MAXWELL COLVER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12188A NORTH MERIDIAN STREET SUITE 250
CARMEL IN
46032
US

IV. Provider business mailing address

12188A NORTH MERIDIAN STREET SUITE 250
CARMEL IN
46032
US

V. Phone/Fax

Practice location:
  • Phone: 317-571-1637
  • Fax: 317-571-9483
Mailing address:
  • Phone: 317-571-1637
  • Fax: 317-571-9483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number01031208A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: