Basic Information
Provider Information
NPI: 1861419525
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARORA
FirstName: REBECCA
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5700 SOUTHWYCK BLVD
Address2:  
City: TOLEDO
State: OH
PostalCode: 436141509
CountryCode: US
TelephoneNumber: 8002888325
FaxNumber: 4198665453
Practice Location
Address1: 10291 N MERIDIAN ST
Address2: STE 100
City: INDIANAPOLIS
State: IN
PostalCode: 462901000
CountryCode: US
TelephoneNumber: 7659833134
FaxNumber: 7659833236
Other Information
ProviderEnumerationDate: 07/17/2006
LastUpdateDate: 05/05/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/05/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102X01057761AINY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

ID Information
IDTypeStateIssuerDescription
00000073012601 ANTHEMOTHER
20103229005IN MEDICAID


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