Provider Demographics
NPI:1215902671
Name:RICH, WENDY J (MD)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:J
Last Name:RICH
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:PO BOX 6069
Mailing Address - Street 2:DEPT 201
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-6069
Mailing Address - Country:US
Mailing Address - Phone:866-282-7905
Mailing Address - Fax:800-731-0751
Practice Address - Street 1:9202 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1800
Practice Address - Country:US
Practice Address - Phone:317-538-4769
Practice Address - Fax:317-570-4571
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01038552202K00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100362490Medicaid
IN716740Medicare PIN
IN254780AMedicare PIN
IN100362490Medicaid