Edward Paul Todderud, MD

Individual provider Active NPI Orthopaedic Surgery Physician · Indianapolis, IN

NPI 1891729463 · NPPES record last updated Dec 3, 2015

Key facts

NPI
1891729463
Entity type
Individual (NPI type 1)
Primary specialty
Orthopaedic Surgery Physician 207X00000X
License
01032114A (IN)
Practice address
7930 N Shadeland Ave
Indianapolis, IN 46250
Phone
(317) 621-6725
Fax
(317) 621-4545
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 8

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

State licenses

LicenseStateTypeSpecialty
01032114AINMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospitals of Indiana Inc Past
since Sep 15, 2010
Accepting new patients
Community Health Network, Inc Past
since Jun 8, 2009
Accepting new patients
Community Hospitals of Indiana Inc Past
since Sep 23, 2009
Accepting new patients
Community Hospitals of Indiana Inc Past
since May 1, 2010
Accepting new patients
Major Hospital Past Accepting new patients
Community Hospitals of Indiana Inc Past
since Jul 13, 2009
Accepting new patients
Community Hospitals of Indiana Inc Past
since May 1, 2009
Accepting new patients
Community Hospitals of Indiana Inc Past
since Mar 6, 2008
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 01032114A IN Yes

Addresses

Primary practice location

7930 N Shadeland Ave
Indianapolis, IN 46250

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2805

Other identifiers

IdentifierTypeStateIssuer
000000764715OtherINANTHEM
P01133606OtherINMEDICARE RAILROAD
100085330MedicaidIN

Other providers in Indianapolis, IN

All providers in Indianapolis, IN · Orthopaedic Surgery Physician in Indiana

Sources for this page

Verify at the official NPI Registry.