Fort Wayne Medical Education Program
Family Medicine in Fort Wayne, IN. Organization (NPI-2).
NPI number1184635153
StatusActive
Last updated in NPPESApr 20, 2015
Details
- NPI
- 1184635153
- Entity type
- Organization (NPI-2)
- Legal business name
- Fort Wayne Medical Education Program
- Organization subpart
- No
- Enumeration date
- Aug 11, 2006
- Last updated
- Apr 20, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- The Family Medicine Center (Doing Business As)
Practice location
750 BroadwaySuite 350
Fort Wayne, IN 46802-1412
Phone 260-423-2675 · Fax 260-423-6621
Mailing address
750 BroadwaySuite 150
Fort Wayne, IN 46802-1412
Phone 260-423-2682 · Fax 260-422-4326
Authorized official
Kimberly Harris
Chief Operating Officer
2604232682
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