Provider Demographics
NPI:1346275203
Name:CATER, ROBERT C (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:CATER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RIPPLE
Other - Middle Name:
Other - Last Name:MEDICAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LLC
Mailing Address - Street 1:PO BOX 40036
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-0036
Mailing Address - Country:US
Mailing Address - Phone:317-372-0575
Mailing Address - Fax:317-875-7101
Practice Address - Street 1:1300 E 86TH ST
Practice Address - Street 2:40036
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1910
Practice Address - Country:US
Practice Address - Phone:317-372-0575
Practice Address - Fax:317-875-7101
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01042411207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000711101OtherANTHEM BCBS (SVMG)
IN100376250CMedicaid
IN247670AOtherMEDICARE NUMBER
IN100376250CMedicaid
INM400049777Medicare PIN