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
| License | State | Type | Specialty |
|---|---|---|---|
| 01037488 | IN | MD | Anesthesiology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100324700 | Medicaid | IN |
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All providers in Indianapolis, IN · Anesthesiology Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.