Healthcare Provider Details

I. General information

NPI: 1215203559
Provider Name (Legal Business Name): MEGAN ELYSE BUECHEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8402 HARCOURT RD STE 420
INDIANAPOLIS IN
46260-2053
US

IV. Provider business mailing address

8402 HARCOURT RD STE 420
INDIANAPOLIS IN
46260-2053
US

V. Phone/Fax

Practice location:
  • Phone: 317-415-6740
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number31926
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number01081473A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: