Provider Demographics
NPI:1285827196
Name:SAXENA, INDIRA R (MD)
Entity Type:Individual
Prefix:DR
First Name:INDIRA
Middle Name:R
Last Name:SAXENA
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 1:311 E WARWICK DR
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1088
Mailing Address - Country:US
Mailing Address - Phone:989-463-1472
Mailing Address - Fax:989-463-2249
Practice Address - Street 1:311 E WARWICK DR
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1013
Practice Address - Country:US
Practice Address - Phone:989-463-1472
Practice Address - Fax:989-463-2249
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301035547207VG0400X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1602931161OtherBCBSM
MI2093340Medicaid
MIM17670027Medicare PIN
MI2093340Medicaid