MEDICARE: DR. ALAN J WATANABE M.D.

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	01032855	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000991459	OTHER	IN	ANTHEM PIN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518961507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN J WATANABE M.D.

Provider Business Mailing Address
First Line	:	2955 FRANKLIN DR
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-2911
Country	:	US
Telephone Number	:	812-342-7583
Fax Number	:

Provider Business Practice Location Address
First Line	:	4050 CENTRAL AVENUE
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47203
Country	:	US
Telephone Number	:	812-376-9427
Fax Number	:

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

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	01/14/2026

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