| 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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