Healthcare Provider Details

I. General information

NPI: 1588663983
Provider Name (Legal Business Name): RAYMOND M HARWOOD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 12/15/2020
Certification Date: 12/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 HARCOURT RD STE 200
INDIANAPOLIS IN
46260-2081
US

IV. Provider business mailing address

12062 HOBBY HORSE DR
CARMEL IN
46032-6330
US

V. Phone/Fax

Practice location:
  • Phone: 317-415-6600
  • Fax: 317-415-6649
Mailing address:
  • Phone: 317-566-8191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number01036612
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: