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NPI Code Detail

MEDICARE: MARGARET R WARDLOW

MEDICARE: MARGARET R WARDLOW
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
1104100000XSocial Worker33008584AIN

General Provider Information

NPI Number : 1831710201
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET R WARDLOW
Provider Business Mailing Address
First Line : 2121 LAKE AVENUE
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-6915
Country : US
Telephone Number : 260-715-8256
Fax Number :
Provider Business Practice Location Address
First Line : 2121 LAKE AVENUE
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-6915
Country : US
Telephone Number : 260-715-8256
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2020
Last Update Date : 09/28/2021

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Directions to “ MARGARET R WARDLOW ” Practice Location

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