MEDICARE: KATHLEEN LYNN BEMENDERFER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	01036273A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01157028	OTHER	IN	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000647923	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1073595013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN LYNN BEMENDERFER MD

Provider Business Mailing Address
First Line	:	7700 SARGENT RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-1833
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7700 SARGENT RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-1833
Country	:	US
Telephone Number	:	--
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	05/09/2023

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