Dandrae Douse, MD is a
Preventive Medicine - Undersea And Hyperbaric Medicine physician based in Kendallville, Indiana. Dandrae Douse is licensed to practice in Indiana (license number 01028388) and his current practice location is 401 N Sawyer Rd, Kendallville, Indiana. He can be reached at his office (for appointments etc.) via phone at
(260) 347-8610.
NPI number for Dandrae Douse is 1609876531 and his current mailing address is 11109 Parkview Plaza Dr # 117, Fort Wayne, Indiana. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1609876531.
Physician's Profile
| Full Name | Dandrae Douse |
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| Gender | Male |
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| Speciality | Preventive Medicine - Undersea And Hyperbaric Medicine |
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| Location | 401 N Sawyer Rd, Kendallville, Indiana |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1609876531
- Provider Enumeration Date: 07/21/2005
- Last Update Date: 10/11/2022
Medical Identifiers
Medical identifiers for Dandrae Douse such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609876531 | NPI | - | NPPES |
| 1235 | Other | IN | PHP |
| 100322930A | Medicaid | IN | |
| 000000082078 | Other | IN | ANTHEM BC/BS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207L00000X | Anesthesiology | 01028388A (Indiana) | Secondary |
| 2083P0011X | Preventive Medicine - Undersea And Hyperbaric Medicine | 01028388 (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dandrae Douse is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dandrae Douse, MD
11109 Parkview Plaza Dr # 117,
Fort Wayne, IN 46845-1701
Ph: () - | Dandrae Douse, MD
401 N Sawyer Rd,
Kendallville, IN 46755-2568
Ph: (260) 347-8610 |
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