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General NPI Number Information
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NPI Number | 1700820727
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Entity Type | Individual
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Provider Name | ROBERTA M PATTERSON PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 04/04/2013
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Provider Practice Location Address
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Address Line | 4880 CENTURY PLAZA RD STE 265
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-5471
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Country | US
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Telephone | 317-216-2700
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Fax | 317-216-2777
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Provider Business Mailing Address
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Address Line | 950 N MERIDIAN ST STE 500 - PROVIDER ENROLLMENT
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-3908
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Country | US
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Telephone | 317-962-4941
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Fax | 317-962-4950
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 10000845
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License Number State | IN
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