Provider Demographics
NPI:1588663983
Name:HARWOOD, RAYMOND M (MD)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:M
Last Name:HARWOOD
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 1:12062 HOBBY HORSE DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-6330
Mailing Address - Country:US
Mailing Address - Phone:317-566-8191
Mailing Address - Fax:
Practice Address - Street 1:8301 HARCOURT RD
Practice Address - Street 2:STE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2081
Practice Address - Country:US
Practice Address - Phone:317-415-6600
Practice Address - Fax:317-415-6649
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01036612207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100327450Medicaid
IN100327450Medicaid
IN796030EMedicare ID - Type Unspecified