| David K Powell, MD | |
| 3707 New Vision Dr, Fort Wayne, IN 46845-1702 | |
| (260) 471-9466 | |
| Not Available | 
| Full Name | David K Powell | 
|---|---|
| Gender | Male | 
| Speciality | Radiology - Diagnostic Radiology | 
| Location | 3707 New Vision Dr, 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 | 
|---|---|---|---|
| 1336193424 | NPI | - | NPPES | 
| 2100612 | Medicaid | OH | |
| 000000092607 | Other | IN | ANTHEM | 
| 1712 | Other | IN | PHP | 
| 100323460 | Medicaid | IN | |
| 4074942100 | Medicaid | MI | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 02037906 (Indiana) | Primary | 
| Entity Name | Fort Wayne Radiology Associates Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1063475861 PECOS PAC ID: 5294624060 Enrollment ID: O20040329000698 | 
| Entity Name | P.e.t. Imaging Services, Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1992768691 PECOS PAC ID: 2668412842 Enrollment ID: O20050506000346 | 
| Mailing Address | Practice Location Address | 
|---|---|
| David K Powell, MD 3707 New Vision Dr, Fort Wayne, IN 46845-1702 Ph: (260) 471-9466 | David K Powell, MD 3707 New Vision Dr, Fort Wayne, IN 46845-1702 Ph: (260) 471-9466 | 
| Dr. Benjamin Jon Moreno, MD, PHD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3707 New Vision Dr Ste 110, Fort Wayne, IN 46845 Phone: 260-469-6602 Fax: 260-484-5919 | |
| Dr. Andre Byard Stovall, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 5001 Us Highway 30 W Ste D, Fort Wayne, IN 46818 Phone: 260-432-1568 Fax: 260-432-4969 | |
| Dr. Christopher Edson Carrel, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3707 New Vision Dr, Fort Wayne, IN 46845 Phone: 604-696-6022 Fax: 616-363-7290 | |
| Dr. Gregg R Mattison, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 3707 New Vision Drive, Fort Wayne, IN 46895 Phone: 260-471-9466 Fax: 260-484-5919 | |
| Christopher M Wing, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3707 New Vision Dr, Fort Wayne, IN 46845 Phone: 260-471-9466 Fax: 260-484-5919 | |
| Dr. Ahdy Messiha, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 7950 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-432-1568 Fax: 260-432-4969 | |
| Vivek K. Sharma, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 5001 Us Highway 30 W Ste D, Fort Wayne, IN 46818 Phone: 260-432-1568 Fax: 260-432-4969 |