MEDICARE: KATIE E MACHANDA 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	207R00000X	Internal Medicine Physician	35085743	OH
2	208000000X	Pediatrics Physician	35-085743	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2638917	OTHER	OH	BCMH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000221389	OTHER	OH	UNISON
5	363791	OTHER	OH	WELLCARE
6	7410792	OTHER	OH	AETNA
7	000000391796	OTHER	OH	ANTHEM
8	745938	OTHER	OH	BUCKEYE
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063542025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE E MACHANDA MD

Provider Business Mailing Address
First Line	:	7140 PORT SYLVANIA DR
Second Line	:	SUITE 420
City	:	TOLEDO
State	:	OH
Zip	:	43617-1176
Country	:	US
Telephone Number	:	419-843-8145
Fax Number	:	419-841-7735

Provider Business Practice Location Address
First Line	:	7140 PORT SYLVANIA DR
Second Line	:	SUITE 420
City	:	TOLEDO
State	:	OH
Zip	:	43617-1176
Country	:	US
Telephone Number	:	419-843-8145
Fax Number	:	419-841-7735

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

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	11/03/2023

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Directions to “ KATIE E MACHANDA MD” Practice Location

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