Provider Demographics
NPI:1760822480
Name:WARENKO, MARY KAREN (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KAREN
Last Name:WARENKO
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 1:1950 MULSANNE DR
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-9076
Mailing Address - Country:US
Mailing Address - Phone:317-435-5081
Mailing Address - Fax:
Practice Address - Street 1:1950 MULSANNE DR
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-9076
Practice Address - Country:US
Practice Address - Phone:317-435-5081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01050291A208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice