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NPI Code Detail

MEDICARE: MARIANNE WATKINS MD

MEDICARE: MARIANNE WATKINS 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
1207VG0400XGynecology Physician01044115AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1160050660OTHERINRAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891785200
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANNE WATKINS MD
Provider Business Mailing Address
First Line : 2518 E DUPONT RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-1675
Country : US
Telephone Number : 260-432-4400
Fax Number : 260-969-6898
Provider Business Practice Location Address
First Line : 2518 E DUPONT RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-1675
Country : US
Telephone Number : 260-432-4400
Fax Number : 260-969-6898
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2005
Last Update Date : 01/31/2018

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