Provider Demographics
NPI:1699724773
Name:FUECHTMAN, MARGARET (CRNA)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:FUECHTMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 MACARTHUR BOULEVARD
Mailing Address - Street 2:ANESTHESIA DEPARTMENT
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2901
Mailing Address - Country:US
Mailing Address - Phone:219-836-7040
Mailing Address - Fax:219-513-1127
Practice Address - Street 1:901 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-3901
Practice Address - Country:US
Practice Address - Phone:219-836-1600
Practice Address - Fax:219-513-1127
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2815166A174400000X
IN28151669A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200391350AMedicaid
IN000000248236OtherANTHEM BCBS
INCA9120MMedicare PIN
INOTH 000Medicare UPIN