| Anthony Medical Associates P C | |
|
1330 N Coliseum Blvd Fort Wayne IN 46805-5526 | |
| (260) 447-8982 | |
| (260) 447-4483 |
| Full Name | Anthony Medical Associates P C |
|---|---|
| Speciality | Family Medicine |
| Location | 1330 N Coliseum Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Charles L Coats (MD OWNER) |
| Authorized Official Contact | 2604478982 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony Medical Associates P C 1330 N Coliseum Blvd Fort Wayne IN 46805-5526 Ph: (260) 447-8982 | Anthony Medical Associates P C 1330 N Coliseum Blvd Fort Wayne IN 46805-5526 Ph: (260) 447-8982 |
| NPI Number | 1003892555 |
|---|---|
| Provider Enumeration Date | 12/16/2005 |
| Last Update Date | 10/24/2014 |
| Medicare PECOS PAC ID | 8123932472 |
|---|---|
| Medicare Enrollment ID | O20031119000493 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003892555 | NPI | - | NPPES |
| 200401400A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Charles L Coats |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700887262 PECOS PAC ID: 0547174898 Enrollment ID: I20050128000801 |
| Provider Name | Sherri A Stiles Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922154426 PECOS PAC ID: 0941477335 Enrollment ID: I20120126000169 |
| Provider Name | John T Oo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396265864 PECOS PAC ID: 5092088922 Enrollment ID: I20170829000800 |
| Provider Name | Michele L Viers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639637341 PECOS PAC ID: 6709114127 Enrollment ID: I20190823000203 |
| Provider Name | Mya Yee Nandar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710584834 PECOS PAC ID: 5092134312 Enrollment ID: I20201006000084 |
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