Healthcare Provider Details

I. General information

NPI: 1437416310
Provider Name (Legal Business Name): ASHWIN REDDY MADUPU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3620 W BETHEL AVE
MUNCIE IN
47304-5407
US

IV. Provider business mailing address

13225 N MERIDIAN ST
CARMEL IN
46032-5480
US

V. Phone/Fax

Practice location:
  • Phone: 765-283-0150
  • Fax: 765-283-0145
Mailing address:
  • Phone: 317-228-7000
  • Fax: 317-228-2321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number01073745A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01073745A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: