Provider Demographics
NPI:1063673358
Name:TAKAGI, VIRGINIA ANN DANGERFIELD (MD)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:ANN DANGERFIELD
Last Name:TAKAGI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8051 S EMERSON AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237
Mailing Address - Country:US
Mailing Address - Phone:317-865-3600
Mailing Address - Fax:317-885-3850
Practice Address - Street 1:1205 HADLEY RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-1737
Practice Address - Country:US
Practice Address - Phone:317-584-3454
Practice Address - Fax:317-584-3435
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01068193A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200997240Medicaid