Healthcare Provider Details

I. General information

NPI: 1992874051
Provider Name (Legal Business Name): RAMA M JAGER MD, PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 12/03/2023
Certification Date: 12/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 E 86TH ST STE 107
INDIANAPOLIS IN
46240-1852
US

IV. Provider business mailing address

931 E 86TH ST STE 107
INDIANAPOLIS IN
46240-1852
US

V. Phone/Fax

Practice location:
  • Phone: 317-418-8110
  • Fax: 317-252-5757
Mailing address:
  • Phone: 317-418-8110
  • Fax: 317-252-5757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number01028376A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number01028376A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: