MEDICARE: KAREN L ROOS MD

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	2084N0400X	Neurology Physician	01034313A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000087173	OTHER	IN	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306869334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN L ROOS MD

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:	STE 130 PROVIDER ENROLLMENT
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	355 W 16TH ST
Second Line	:	SUITE 3200
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-2207
Country	:	US
Telephone Number	:	317-963-7400
Fax Number	:	317-963-7425

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	01/29/2021

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Directions to “ KAREN L ROOS MD” Practice Location

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