| Daniel Abraha, MD | |
|
7950 W Jefferson Blvd, Suite 210, Fort Wayne, IN 46804-4140 | |
| (260) 435-7355 | |
| (260) 435-7637 |
| Full Name | Daniel Abraha |
|---|---|
| Gender | Male |
| Speciality | Pediatrics - Pediatric Critical Care Medicine |
| Location | 7950 W Jefferson Blvd, Fort Wayne, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063419166 | NPI | - | NPPES |
| 200816520 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080P0203X | Pediatrics - Pediatric Critical Care Medicine | 01061925A (Indiana) | Primary |
| Entity Name | Lutheran Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164662805 PECOS PAC ID: 4981751617 Enrollment ID: O20090414000705 |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel Abraha, MD 6920 Pointe Inverness Way Ste 200, Fort Wayne, IN 46804-7934 Ph: (260) 479-3516 | Daniel Abraha, MD 7950 W Jefferson Blvd, Suite 210, Fort Wayne, IN 46804-4140 Ph: (260) 435-7355 |
Dr. Melissa S Rice, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 11115 Parkview Plaza Dr, Fort Wayne, IN 46845 Phone: 260-672-6443 Fax: 260-672-6459 | |
Vaneska Bottino Da Costa, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 7950 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-435-7001 Fax: 260-435-9763 | |
Ronald R Hall, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1717 S Calhoun St, Fort Wayne, IN 46802 Phone: 260-458-2641 Fax: 260-969-0007 | |
Mrs. Lindsay M Ligler, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2810 Dupont Commerce Ct, Fort Wayne, IN 46825 Phone: 260-490-7337 | |
Osita Victor Ezeakudo, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2510 E Dupont Rd, Suite 200, Fort Wayne, IN 46825 Phone: 260-432-4913 Fax: 260-969-6832 | |
Dr. Michael Philip Dick, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3898 New Vision Dr, Fort Wayne, IN 46845 Phone: 260-425-5750 Fax: 260-425-5755 | |
Pamela Thomas, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 7950 W Jefferson Blvd, Suite 210, Fort Wayne, IN 46804 Phone: 260-432-2297 Fax: 260-434-6420 |