Provider Demographics
NPI:1225072929
Name:VALLION, ROBERT DEAN (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DEAN
Last Name:VALLION
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 1:950 N MERIDIAN ST
Mailing Address - Street 2:STE 500 PROVIDER ENROLLMENT
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-3908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:710 NO EAST STREET
Practice Address - Street 2:
Practice Address - City:WABASH
Practice Address - State:IN
Practice Address - Zip Code:46992
Practice Address - Country:US
Practice Address - Phone:260-569-2324
Practice Address - Fax:260-569-2376
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01051793A207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000544590OtherANTHEM PIN (ICCC)
IN200240780Medicaid
IN000000544590OtherANTHEM PIN (ICCC)
INM400037570Medicare PIN
INP01059171Medicare PIN
IN114620LLMedicare PIN
IN200240780Medicaid
INP00618654Medicare PIN