Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 01077008A | IN |
N | 207L00000X | Anesthesiologist | 11017448A | IN |
NPI | 1013357474 |
---|---|
Provider Name | Makoto Kataoka |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-1239 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2013 |
Last Update Date | 02/02/2022 |