Healthcare Provider Details

I. General information

NPI: 1699416172
Provider Name (Legal Business Name): RUTH AMARACHI OSBORNE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E MAIN ST
DANVILLE IN
46122-1948
US

IV. Provider business mailing address

1000 E MAIN ST
DANVILLE IN
46122-1948
US

V. Phone/Fax

Practice location:
  • Phone: 317-718-4740
  • Fax: 317-718-6740
Mailing address:
  • Phone: 317-837-5566
  • Fax: 317-718-6793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01100619A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: