MEDICARE: JOHN A WARDEN 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	207RP1001X	Pulmonary Disease Physician	01025470A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629070594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN A WARDEN M.D.

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:	STE 130 PROVIDER ENROLLMENT
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 N RONALD REAGAN PARKWAY
Second Line	:	SUITE 206
City	:	AVON
State	:	IN
Zip	:	46123-6911
Country	:	US
Telephone Number	:	317-272-8050
Fax Number	:	317-272-8051

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	02/26/2014

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Directions to “ JOHN A WARDEN M.D.” Practice Location

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