Jonathan M Anagnostou, MD

Individual provider Active NPI Anesthesiology Physician · Indianapolis, IN

NPI 1770548448 · NPPES record last updated Jan 8, 2010

Key facts

NPI
1770548448
Entity type
Individual (NPI type 1)
Primary specialty
Anesthesiology Physician 207L00000X
License
01037488 (IN)
Practice address
550 University Blvd
Indianapolis, IN 46202-5149
Phone
(317) 274-0273
Fax
(317) 567-2191
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01037488INMDAnesthesiology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01037488 IN Yes

Addresses

Primary practice location

550 University Blvd
Indianapolis, IN 46202-5149

Mailing address

1120 South Dr
Fesler Hall, RM. 204
Indianapolis, IN 46202-5135
Phone (317) 274-0273

Other identifiers

IdentifierTypeStateIssuer
100324700MedicaidIN

Other providers in Indianapolis, IN

All providers in Indianapolis, IN · Anesthesiology Physician in Indiana

Sources for this page

Verify at the official NPI Registry.