Healthcare Provider Details

I. General information

NPI: 1154647220
Provider Name (Legal Business Name): CAROLINE ELIZABETH ROUSE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2010
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N. UNIVERSITY BOULEVARD, UH 2440
INDIANAPOLIS IN
46202-0001
US

IV. Provider business mailing address

550 N. UNIVERSITY BOULEVARD, UH 2440
INDIANAPOLIS IN
46202
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-8182
  • Fax: 317-944-7417
Mailing address:
  • Phone: 317-944-8182
  • Fax: 317-944-7417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberML60156663
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number01078682A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01078682A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: