Dr. Michael James Bangert, MIchael Bangert, OD
Optometrist in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1629124151
StatusActive
Last updated in NPPESJul 30, 2013
Details
- NPI
- 1629124151
- Entity type
- Individual (NPI-1)
- Name
- Dr. Michael James Bangert
- Credential
- MIchael Bangert, OD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 26, 2007
- Last updated
- Jul 30, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 18001776B | IN | Yes |
Other names
- Michael James Bangert (Other Name)
Practice location
4626 W Jefferson BlvdFort Wayne, IN 46804-6826
Phone 260-432-5502 · Fax 260-432-8415
Mailing address
4626 W Jefferson BlvdFort Wayne, IN 46804-6826
Phone 260-432-5502 · Fax 260-432-8415
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