Provider Demographics
NPI:1093895450
Name:QUATE-OPERACZ, MARGARET ANN (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:QUATE-OPERACZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3665 PARK PL W
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-3566
Mailing Address - Country:US
Mailing Address - Phone:574-607-4724
Mailing Address - Fax:574-607-4725
Practice Address - Street 1:3665 PARK PL W
Practice Address - Street 2:SUITE 300
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-3566
Practice Address - Country:US
Practice Address - Phone:574-607-4724
Practice Address - Fax:574-607-4725
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01063507A207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000696783OtherBCBS
IN200862790Medicaid
IN000000696783OtherBCBS
M400037654Medicare PIN