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NPI Code Detail

MEDICARE: RONALD REISMAN MD

MEDICARE: RONALD REISMAN 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
1207RP1001XPulmonary Disease Physician01027146AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609861988
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONALD REISMAN MD
Provider Business Mailing Address
First Line : 8840 COMMERCE PARK PL STE E
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-3129
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8050 TOWNSHIP LINE RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-2478
Country : US
Telephone Number : 317-415-8500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 02/23/2015

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