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1265435036

NPI Code Detail

MEDICARE: MARGARET A BRENGLE MD

MEDICARE: MARGARET A BRENGLE 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	2085R0202X	Diagnostic Radiology Physician	01042639A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	300117844	OTHER	IN	RR MEDICARE-351158723
3	M400062710	OTHER	IN	MEDICARE SVMG

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	005589	OTHER	IN	SIHO-351158723
4	000000182491	OTHER	IN	ANTHEM-351158723
5	000000492337	OTHER	IN	ANTHEM 203778927
6	084360	OTHER	IN	HEALTH ALLIANCE-351158723
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	Q0086024	OTHER	IN	CMOSHO351158723&352047427

General Provider Information

NPI Number	:	1265435036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET A BRENGLE MD

Provider Business Mailing Address
First Line	:	5901 TECHNOLOGY CENTER DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-6013
Country	:	US
Telephone Number	:	317-328-5050
Fax Number	:	317-715-9965

Provider Business Practice Location Address
First Line	:	5901 TECHNOLOGY CENTER DR.
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-6013
Country	:	US
Telephone Number	:	317-328-5050
Fax Number	:	317-715-9965

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	03/18/2014

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Directions to “ MARGARET A BRENGLE MD” Practice Location

Language	Start Address	Practice Location

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