Provider Demographics
NPI:1316946684
Name:OSCHERWITZ, NANETTE B (MD)
Entity type:Individual
Prefix:
First Name:NANETTE
Middle Name:B
Last Name:OSCHERWITZ
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 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8075 N SHADELAND AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2693
Practice Address - Country:US
Practice Address - Phone:317-355-9766
Practice Address - Fax:317-355-9774
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058130A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200452440Medicaid
IN5877211OtherAETNA
INP01198084OtherRR MEDICARE PTAN
INF59047Medicare UPIN
INP01198084OtherRR MEDICARE PTAN
IN251320JMedicare PIN
IN248520JJMedicare PIN
IN5877211OtherAETNA
IN230360CMedicare PIN
IN200452440Medicaid