Provider Demographics
NPI:1174523351
Name:AROUTIOUNOVA, INNA (MD)
Entity type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:AROUTIOUNOVA
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 1:6626 E 75TH ST
Mailing Address - Street 2:STE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3660 GUION RD
Practice Address - Street 2:STE 224
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-1697
Practice Address - Country:US
Practice Address - Phone:317-920-3000
Practice Address - Fax:317-613-3065
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056223A207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP01424282OtherRAIL ROAD
IN000000748888OtherANTHEM BCBS
IN200452920Medicaid
IN000000748888OtherANTHEM BCBS
IN266180418Medicare PIN
INM400063951Medicare PIN