Dr. Ryan Glenn Hartig, M.D.
General Practice in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1053747741
StatusActive
Last updated in NPPESFeb 21, 2025
Details
- NPI
- 1053747741
- Entity type
- Individual (NPI-1)
- Name
- Dr. Ryan Glenn Hartig
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 25, 2013
- Certification date
- Feb 21, 2025
- Last updated
- Feb 21, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - GENERAL PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | 01076905A | IN | Yes |
Practice location
4666 W Jefferson Blvd Ste 170Fort Wayne, IN 46804-6893
Phone 260-207-4137
Mailing address
4666 W Jefferson Blvd Ste 170Fort Wayne, IN 46804-6893
Is something wrong?
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