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General NPI Number Information
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NPI Number | 1861408981
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Entity Type | Individual
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Provider Name | ROBERT H. DORWART M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 08/12/2011
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Provider Practice Location Address
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Address Line | 11900 N. PENNSYLVANIA STREET SUITE 100
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City | CARMEL
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State | IN
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Zip | 46032-4694
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Country | US
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Telephone | 317-846-0717
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Fax | 317-846-0557
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Provider Business Mailing Address
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Address Line | P.O. BOX 2303 DEPT 163
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City | INDIANAPOLIS
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State | IN
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Zip | 46206-2303
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Country | US
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Telephone | 952-542-8553
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Fax | 952-513-6880
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 33418
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01039239A
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License Number State | IN
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