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Rony Shabou, MD

Internal Medicine in Fort Wayne, IN. Individual provider (NPI-1).

NPI number1982131355
StatusActive
Last updated in NPPESJan 2, 2024

Details

NPI
1982131355
Entity type
Individual (NPI-1)
Name
Rony Shabou
Credential
MD
Sex
Male
Sole proprietor
Yes
Enumeration date
May 17, 2017
Certification date
Jan 2, 2024
Last updated
Jan 2, 2024

Medicare and OIG

Medicare enrolled (PECOS)
Yes · PRACTITIONER - INTERNAL MEDICINE
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 codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine01083993AINYes
207R00000X Internal Medicine4301500546MI

Practice location

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701

Phone 260-672-6620 · Fax 260-672-6639

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Internal Medicine Physician providers in Fort Wayne, IN

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