Provider Demographics
NPI:1861408981
Name:DORWART, ROBERT H (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:DORWART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2303
Mailing Address - Street 2:DEPT 163
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-2303
Mailing Address - Country:US
Mailing Address - Phone:952-542-8553
Mailing Address - Fax:952-513-6880
Practice Address - Street 1:11900 N. PENNSYLVANIA STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4694
Practice Address - Country:US
Practice Address - Phone:317-846-0717
Practice Address - Fax:317-846-0557
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ334182085R0202X
IN01039239A2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A46667Medicare UPIN