JAN MAGNO DE GUZMAN MD NPI 1477083848

NPI Information

NPI: 1477083848
Provider Name: JAN MAGNO DE GUZMAN, MD
Classification: Family Medicine - 207QA0505X
Entity Type: Individual

Specialization: Adult Medicine

Organization: INDIANA UNIVERSITY HEALTH BALL MEMORIAL PHYSICIANS INC

PECOS Registration: Yes

Address:
10215 AUBURN PARK DR
FORT WAYNE, IN
ZIP 46825
Phone: (260) 234-5400
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Jan Magno De Guzman, MD is an adult medicine family medicine in Fort Wayne, IN with 7 years of experience. The provider is definition to come. Jan Magno De Guzman, MD NPI is 1477083848. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2017

The provider's business location address is:

10215 AUBURN PARK DR
FORT WAYNE, IN
ZIP 46825-387
Phone: (260) 234-5400
Fax: (260) 234-5110

The NPI 1477083848 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/18/2017 and was last updated on 12/15/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0505X	Family Medicine	Adult Medicine	01083919A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	11019468A	OTHER	INDIANA	STATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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