Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 01037585 | IN |
NPI | 1265541262 |
---|---|
Provider Name | Robert K Darragh |
First Address | Indianapolis, IN 46206-1026 |
Second Address | Indianapolis, IN 46202-5109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 05/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000354893 | ANTHEM-DEAC-350593390 (01) | |
100130120 | (05) | IN |
1802204 | (05) | LA |
350593390-042 | TRICARE-DEAC-350593390 (01) | |
64879885 | (05) | KY |
E30367 | (02) |