MEDICARE: MARIA E FAGET 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	207V00000X	Obstetrics & Gynecology Physician	01072028A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01072028A	OTHER	IN	STATE LICENSE
2	16563	OTHER	PR	STATE LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932307527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA E FAGET MD

Provider Business Mailing Address
First Line	:	30 W RAMPART ST STE 200
Second Line	:
City	:	SHELBYVILLE
State	:	IN
Zip	:	46176-8846
Country	:	US
Telephone Number	:	317-421-2012
Fax Number	:	317-398-1851

Provider Business Practice Location Address
First Line	:	2451 INTELLIPLEX DR STE 230
Second Line	:
City	:	SHELBYVILLE
State	:	IN
Zip	:	46176-8581
Country	:	US
Telephone Number	:	317-398-0193
Fax Number	:	317-398-0727

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

Provider Enumeration Date	:	07/05/2007
Last Update Date	:	07/12/2024

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Directions to “ MARIA E FAGET MD” Practice Location

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