Fort Wayne Medical Education Program

NPI 1184635153 - Family Medicine - 207Q00000X

NPI Details
NPI 1184635153
Enumeration Date 08/11/2006
Last Updated 04/20/2015
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name KIMBERLY KIMBERLY
Position CHIEF OPERATING OFFICER
Phone (260) 423-2675
Fax (260) 423-6621
Practice Location
750 BROADWAY
SUITE 350
FORT WAYNE IN, 46802-1412, US
Phone (260) 423-2675
Fax (260) 423-6621
Business Location
750 BROADWAY
SUITE 150
FORT WAYNE IN, 46802-1412, US
Phone (260) 423-2682
Fax (260) 422-4326
Toxanomy
Taxonomy Code 207Q00000X
License State
License Number
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According to our database, Fort Wayne Medical Education Program NPI is 1184635153, taxonomy code is 207Q00000X Fort Wayne Medical Education Program physically located at 750 Broadway, Fort Wayne IN, 46802-1412. NPI Number 1033115704 has the healthcare provider type.

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1184635153 NPI number is provided on an as is basis without warranty of any kind. 1184635153 is maintained by the National Plan & Provider Enumeration System. The contents of Fort Wayne Medical Education Program are for informational purposes only.