Provider Demographics
NPI:1447694468
Name:MASHINDI, RUDO (MD)
Entity type:Individual
Prefix:MRS
First Name:RUDO
Middle Name:
Last Name:MASHINDI
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:ONE MEMORIAL SQUARE
Mailing Address - Street 2:SUITE 50
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-1270
Mailing Address - Country:US
Mailing Address - Phone:317-468-6270
Mailing Address - Fax:317-468-6268
Practice Address - Street 1:300 E BOYD AVE STE 120
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-2832
Practice Address - Country:US
Practice Address - Phone:317-462-3441
Practice Address - Fax:317-477-6316
Is Sole Proprietor?:No
Enumeration Date:2013-04-21
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036141131207Q00000X, 208M00000X
KYR3267207Q00000X
IN01079770A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100385530Medicaid
KYK202860Medicare PIN