| Allied Physicians Inc | |
|
2510 E Dupont Rd Ste 226 Fort Wayne IN 46825-1603 | |
| (260) 460-3100 | |
| (260) 460-3130 |
| Full Name | Allied Physicians Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2510 E Dupont Rd Ste 226, Fort Wayne, Indiana |
| Authorized Official Name and Position | Isa S Canavati (PRESIDENT) |
| Authorized Official Contact | 2604362416 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Allied Physicians Inc 7956 W Jefferson Blvd Fort Wayne IN 46804-4140 Ph: (260) 436-2416 | Allied Physicians Inc 2510 E Dupont Rd Ste 226 Fort Wayne IN 46825-1603 Ph: (260) 460-3100 |
| NPI Number | 1609867605 |
|---|---|
| Provider Enumeration Date | 10/31/2005 |
| Last Update Date | 12/07/2018 |
| Medicare PECOS PAC ID | 5193625846 |
|---|---|
| Medicare Enrollment ID | O20110815000039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609867605 | NPI | - | NPPES |
| 0515955 | Medicaid | OH | |
| 100277310 | Medicaid | IN | |
| CC1549 | Other | IN | RAILROAD MEDICARE |
| Provider Name | Loi K Phuong |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1841297041 PECOS PAC ID: 1355241910 Enrollment ID: I20040109001106 |
| Provider Name | Marlene C Bultemeyer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083828719 PECOS PAC ID: 2860528148 Enrollment ID: I20101207001227 |
| Provider Name | Isa S Canavati |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1952308413 PECOS PAC ID: 0840190500 Enrollment ID: I20110120000983 |
| Provider Name | Madhav H Bhat |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376540823 PECOS PAC ID: 3375443039 Enrollment ID: I20110204000060 |
| Provider Name | Ajay S Gupta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487651873 PECOS PAC ID: 9931003779 Enrollment ID: I20110204000145 |
| Provider Name | Pamela L Mcmaster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497130272 PECOS PAC ID: 8022327188 Enrollment ID: I20161208002127 |
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