Healthcare Provider Details

I. General information

NPI: 1285827196
Provider Name (Legal Business Name): INDIRA R. SAXENA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 09/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 E WARWICK DR
ALMA MI
48801-1013
US

IV. Provider business mailing address

311 E WARWICK DR
ALMA MI
48801-1088
US

V. Phone/Fax

Practice location:
  • Phone: 989-463-1472
  • Fax: 989-463-2249
Mailing address:
  • Phone: 989-463-1472
  • Fax: 989-463-2249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number4301035547
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301035547
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: