Provider Demographics
NPI:1952340754
Name:MEHL, ROBERT E (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:MEHL
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 1:3524 N MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-4486
Mailing Address - Country:US
Mailing Address - Phone:317-925-0653
Mailing Address - Fax:317-925-0774
Practice Address - Street 1:3524 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-4486
Practice Address - Country:US
Practice Address - Phone:317-925-0653
Practice Address - Fax:317-925-0774
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01037117A2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000523946OtherANTHEM
INP01282456OtherMMS MEDICARE RAILROAD
IN100333180Medicaid
INP00414275OtherMEDICARE RAILROAD
IN000000523946OtherANTHEM
INM400038021Medicare PIN
INE43777Medicare UPIN
INP00414275OtherMEDICARE RAILROAD