Basic Information
| Provider Information | |||||||||
| NPI: | 1588663983 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARWOOD | ||||||||
| FirstName: | RAYMOND | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12062 HOBBY HORSE DR | ||||||||
| Address2: | |||||||||
| City: | CARMEL | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460326330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3175668191 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8301 HARCOURT RD | ||||||||
| Address2: | STE 200 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462602081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3174156600 | ||||||||
| FaxNumber: | 3174156649 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2005 | ||||||||
| LastUpdateDate: | 12/15/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | 01036612 | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 100327450 | 05 | IN | MEDICAID |