NPI 1194888644

Nader Rezvan, MD

Practitioner Specialist Bloomington, IN

Practice location

Address: 601 W 2nd St, Bloomington, IN 47403-2317
Phone: (866) 483-4804
Fax: (317) 870-0499
Mailing address: 2312 N Dunn St, Bloomington, IN 47408-1327

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 01023405 (IN)

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Registry record

NPI: 1194888644
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Dec 2006
Record last updated: 13 May 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.