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NORTHEAST INDIANA GENETIC COUNSELING CENTER INC NPI 1881678860


NPI Information

NPI: 1881678860
Provider Name: NORTHEAST INDIANA GENETIC COUNSELING CENTER INC
Classification: Medical Genetics - 207SG0201X
Entity Type: Organization

Specialization: Clinical Genetics (M.D.)

Address:
11143 PARKVIEW PLAZA DR
STE. 311
FORT WAYNE, IN
ZIP 46845
Phone: (260) 482-3886
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NORTHEAST INDIANA GENETIC COUNSELING CENTER INC is a clinical genetics (m.d.) medical genetics in Fort Wayne, IN. The provider is a clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. NORTHEAST INDIANA GENETIC COUNSELING CENTER INC NPI is 1881678860. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

11143 PARKVIEW PLAZA DR
STE. 311
FORT WAYNE, IN
ZIP 46845-701
Phone: (260) 482-3886
Fax: (260) 482-1910

The provider's authorized official is Patricia I Bader .
The authorized official title is Physician and has the following contact phone number (260) 482-3886.

The enumeration date for this NPI number is 12/2/2005 and was last updated on 5/27/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics01022953INDIANANo
2207SC0300XMedical GeneticsClinical Cytogenetics01022953INDIANANo
3207SG0201XMedical GeneticsClinical Genetics (M.D.)01022953INDIANAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1100080650AMEDICAIDINDIANA
2100360290AMEDICAIDINDIANA
3134660AMEDICARE PININDIANA
4D94671MEDICARE UPININDIANA

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: 4/28/2024

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