MEDICARE: DR. MARGARET REESE WATANABE M.D., PH.D.

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	207VG0400X	Gynecology Physician	01037970A	IN

General Provider Information

NPI Number	:	1639724073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARGARET REESE WATANABE M.D., PH.D.

Provider Business Mailing Address
First Line	:	550 UNIVERSITY BLVD # UH2001
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5149
Country	:	US
Telephone Number	:	317-948-2264
Fax Number	:	317-948-3352

Provider Business Practice Location Address
First Line	:	2325 E NEW YORK ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-3113
Country	:	US
Telephone Number	:	317-948-2264
Fax Number	:	317-948-3352

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

Provider Enumeration Date	:	08/02/2019
Last Update Date	:	08/02/2019

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