Healthcare Provider Details

I. General information

NPI: 1174523351
Provider Name (Legal Business Name): INNA AROUTIOUNOVA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 04/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3660 GUION RD STE 224
INDIANAPOLIS IN
46222-1697
US

IV. Provider business mailing address

6626 E 75TH ST STE 500
INDIANAPOLIS IN
46250-2805
US

V. Phone/Fax

Practice location:
  • Phone: 317-920-3000
  • Fax: 317-613-3065
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number01056223A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: