Provider Demographics
NPI:1750499802
Name:KOLAR, MADELEINE COGAN (MD)
Entity Type:Individual
Prefix:
First Name:MADELEINE
Middle Name:COGAN
Last Name:KOLAR
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 1:2601 COLD SPRING RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-2202
Mailing Address - Country:US
Mailing Address - Phone:317-247-4402
Mailing Address - Fax:317-274-5168
Practice Address - Street 1:550 N MERIDIAN ST STE 114
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1208
Practice Address - Country:US
Practice Address - Phone:317-274-4402
Practice Address - Fax:317-274-5168
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01037721A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN116660BBBMedicare ID - Type Unspecified
INF61877Medicare UPIN