Provider Demographics
NPI:1912587627
Name:MENKE, CELIA ROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:CELIA
Middle Name:ROSE
Last Name:MENKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 WISHARD BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2872
Mailing Address - Country:US
Mailing Address - Phone:317-962-0857
Mailing Address - Fax:317-962-5479
Practice Address - Street 1:1040 WISHARD BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2872
Practice Address - Country:US
Practice Address - Phone:317-962-0857
Practice Address - Fax:317-962-5479
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program