Provider Demographics
NPI:1588769152
Name:WINCHESTER, PAUL D (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:D
Last Name:WINCHESTER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1026
Mailing Address - Country:US
Mailing Address - Phone:317-274-1201
Mailing Address - Fax:317-278-9905
Practice Address - Street 1:8111 S EMERSON AVE
Practice Address - Street 2:NICU
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8601
Practice Address - Country:US
Practice Address - Phone:317-865-5541
Practice Address - Fax:317-865-5148
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2021-02-24
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Provider Licenses
StateLicense IDTaxonomies
IN010539472080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200329100Medicaid
KY64031073Medicaid