Rafael Cruz, M.D.

Individual provider Active NPI Family Medicine Physician · Logansport, IN

NPI 1851310239 · NPPES record last updated Mar 7, 2023

Key facts

NPI
1851310239
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
01046661A (IN)
Practice address
1700 Dividend Dr
Logansport, IN 46947-1572
Phone
(574) 722-7407
Fax
(574) 735-0429
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony L Pollard DO a Professional Corporation Family Medicine Past Accepting new patients
A L Pollard Rainbow Hospitalists Family Medicine Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01046661A IN Yes

Addresses

Primary practice location

1700 Dividend Dr
Logansport, IN 46947-1572

Mailing address

1700 Dividend Dr
Logansport, IN 46947-1572
Phone (574) 722-7407

Other identifiers

IdentifierTypeStateIssuer
1025449080001MedicaidPA
MD-073155-LOtherPAMEDICAL LICENSE
10380OtherNVMEDICAL LICENSE
221853-1OtherNYMEDICAL LICENSE
003102887MedicaidNV
CS11551OtherNVPHARMACY CERTIFICATE

Other providers in Logansport, IN

All providers in Logansport, IN · Family Medicine Physician in Indiana

Sources for this page

Verify at the official NPI Registry.