MEDICARE: CAROLINE ELIZABETH ROUSE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	ML60156663	WA
2	207VM0101X	Maternal & Fetal Medicine Physician	01078682A	IN
3	207V00000X	Obstetrics & Gynecology Physician	01078682A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	896330036	OTHER	IN	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154647220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE ELIZABETH ROUSE M.D.

Provider Business Mailing Address
First Line	:	550 N. UNIVERSITY BOULEVARD, UH 2440
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202
Country	:	US
Telephone Number	:	317-944-8182
Fax Number	:	317-944-7417

Provider Business Practice Location Address
First Line	:	550 N. UNIVERSITY BOULEVARD, UH 2440
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-0001
Country	:	US
Telephone Number	:	317-944-8182
Fax Number	:	317-944-7417

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2010
Last Update Date	:	03/06/2025

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Directions to “ CAROLINE ELIZABETH ROUSE M.D.” Practice Location

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