Healthcare Provider Details

I. General information

NPI: 1568102747
Provider Name (Legal Business Name): MEGHAN CONNOR ROBY DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 W BASSETT RD STE 4
SHELBYVILLE IN
46176-8575
US

IV. Provider business mailing address

30 W RAMPART ST STE 200
SHELBYVILLE IN
46176-8846
US

V. Phone/Fax

Practice location:
  • Phone: 317-421-2663
  • Fax: 317-398-1859
Mailing address:
  • Phone: 317-421-2012
  • Fax: 317-398-1851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number07001485A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: