Northeast Medical Associates, Pc | |
1234 E. Dupont Rd. Suite 6 Fort Wayne IN 46825-1545 | |
(260) 480-2600 | |
(260) 496-8077 |
Full Name | Northeast Medical Associates, Pc |
---|---|
Speciality | Family Medicine |
Location | 1234 E. Dupont Rd., Fort Wayne, Indiana |
Authorized Official Name and Position | Karen Sue Evans (PHYSICIAN) |
Authorized Official Contact | 2604802600 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Northeast Medical Associates, Pc 1234 E. Dupont Rd. Suite 6 Fort Wayne IN 46825-1545 Ph: (260) 480-2600 | Northeast Medical Associates, Pc 1234 E. Dupont Rd. Suite 6 Fort Wayne IN 46825-1545 Ph: (260) 480-2600 |
NPI Number | 1003807850 |
---|---|
Provider Enumeration Date | 11/01/2005 |
Last Update Date | 03/09/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003807850 | NPI | - | NPPES |
1003807850 | Other | IN | GROUP NPI |
7795314 | Other | IN | AETNA PIN |
200335790A | Medicaid | IN | |
CJ8803 | Other | IN | MEDICARE RR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 50004246A (Indiana) | Primary |
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