Healthcare Provider Details

I. General information

NPI: 1902931926
Provider Name (Legal Business Name): ROGER ANDREW PIATEK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13421 OLD MERIDIAN ST STE 200
CARMEL IN
46032-1411
US

IV. Provider business mailing address

13421 OLD MERIDIAN ST STE 200
CARMEL IN
46032-1411
US

V. Phone/Fax

Practice location:
  • Phone: 317-243-3000
  • Fax: 317-246-7729
Mailing address:
  • Phone: 317-243-3000
  • Fax: 317-246-7729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number01036946A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number01036946A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: