Indira Mammen, MD is a
Obstetrics & Gynecology physician based in Cedarburg, Wisconsin. Indira Mammen is licensed to practice in Wisconsin (license number 21773) and her current practice location is 4922 Columbia Rd, Cedarburg, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(262) 375-2829.
NPI number for Indira Mammen is 1427094796 and her current mailing address is 4922 Columbia Rd, Cedarburg, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1427094796.
Physician's Profile
| Full Name | Indira Mammen |
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| Gender | Female |
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| Speciality | Obstetrics & Gynecology |
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| Location | 4922 Columbia Rd, Cedarburg, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1427094796
- Provider Enumeration Date: 06/22/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Indira Mammen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1427094796 | NPI | - | NPPES |
| 30415000 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207V00000X | Obstetrics & Gynecology | 21773 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Indira Mammen is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Indira Mammen, MD
4922 Columbia Rd,
Cedarburg, WI 53012-9188
Ph: (262) 375-2829 | Indira Mammen, MD
4922 Columbia Rd,
Cedarburg, WI 53012-9188
Ph: (262) 375-2829 |
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