Provider Demographics
NPI:1245462332
Name:WOHLREICH, MADELAINE M (MD)
Entity type:Individual
Prefix:DR
First Name:MADELAINE
Middle Name:M
Last Name:WOHLREICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5202 POTTERS PIKE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46234-2934
Mailing Address - Country:US
Mailing Address - Phone:317-679-1402
Mailing Address - Fax:317-388-9744
Practice Address - Street 1:5202 POTTERS PIKE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46234-2934
Practice Address - Country:US
Practice Address - Phone:317-679-1402
Practice Address - Fax:317-388-9744
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD153252084P0800X
PAMD024411E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry