Provider Demographics
NPI:1114912383
Name:SCALES, RICHARD L (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:SCALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7340 SHADELAND STATION
Mailing Address - Street 2:SUITE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3980
Mailing Address - Country:US
Mailing Address - Phone:317-579-2150
Mailing Address - Fax:317-579-2130
Practice Address - Street 1:7340 SHADELAND STATION
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3980
Practice Address - Country:US
Practice Address - Phone:317-579-2150
Practice Address - Fax:317-579-2130
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10304852085R0202X
IN01030485A2085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00024410OtherRR MEDICARE PINS
P00024728OtherRR MEDICARE PINS
P0023646OtherRR MEDICARE PINS
IN300027987OtherRAILROAD MEDICARE
P00023644OtherRR MEDICARE PINS
P00024065OtherRR MEDICARE PINS
300138600OtherRR MEDICARE PINS
P00024067OtherRR MEDICARE PINS
P00024723OtherRR MEDICARE PINS
IN000000076156OtherANTHEM
P00024412OtherRR MEDICARE PINS
IN100320770AMedicaid
P00024411OtherRR MEDICARE PINS
P00024724OtherRR MEDICARE PINS
P00024723OtherRR MEDICARE PINS
P00024411OtherRR MEDICARE PINS
P00024065OtherRR MEDICARE PINS
IND94484Medicare UPIN
152690HMedicare PIN
P00024410OtherRR MEDICARE PINS
IN222750VMedicare PIN