Healthcare Provider Details

I. General information

NPI: 1699907600
Provider Name (Legal Business Name): MAGDALENA DOROTA LEWANDOWSKA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2009
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8326 NAAB RD
INDIANAPOLIS IN
46260-1920
US

IV. Provider business mailing address

8326 NAAB RD
INDIANAPOLIS IN
46260-1920
US

V. Phone/Fax

Practice location:
  • Phone: 317-871-0000
  • Fax: 317-871-0010
Mailing address:
  • Phone: 317-871-0000
  • Fax: 317-871-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01075732A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number240924
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number01075732A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: