Provider Demographics
NPI:1073585006
Name:WALLING, RADHIKA V (MD)
Entity Type:Individual
Prefix:
First Name:RADHIKA
Middle Name:V
Last Name:WALLING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RADHIKA
Other - Middle Name:
Other - Last Name:VEERAPANENI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7979 N SHADELAND AVE
Practice Address - Street 2:STE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2042
Practice Address - Country:US
Practice Address - Phone:317-621-4300
Practice Address - Fax:317-621-4301
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058925A207RH0000X, 207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN7833766OtherAETNA
INP00415789OtherMEDICARE RR
INP01751222OtherRR MEDICARE
IN0652978OtherCIGNA
IN296906OtherWELLCARE
IN000000475174OtherANTHEM
IN200465620Medicaid
IN200465620Medicaid
IN266180790Medicare PIN
IN000000475174OtherANTHEM
IN0652978OtherCIGNA