Healthcare Provider Details

I. General information

NPI: 1376239897
Provider Name (Legal Business Name): MARIA JANE DODSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 RILEY HOSPITAL DRIVE STE. RI 5837
INDIANAPOLIS IN
46202
US

IV. Provider business mailing address

705 RILEY HOSPITAL DRIVE STE. RI 5837
INDIANAPOLIS IN
46202
US

V. Phone/Fax

Practice location:
  • Phone: 317-274-8282
  • Fax:
Mailing address:
  • Phone: 317-274-8282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number02009256A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: