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Contact Information

MARY D ROUSE, MD
6640 INTECH BLVD
SUITE 195
INDIANAPOLIS, IN46278-2011
 Phone: 317-295-0608
 Fax: 317-295-0622
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for MARY D ROUSE · (Female)

NPI # 1578509345
Status Active
Credentials MD
Entity Individual
Enumeration date 06/21/2006
Last updated 12/01/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01040728
  • IN Medicaid 100357530
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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