| Primecare Clinic | |
|
14417 Illinois Rd. Ste B Fort Wayne IN 46814 | |
| (260) 344-4035 | |
| (260) 969-9272 |
| Full Name | Primecare Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 14417 Illinois Rd., Fort Wayne, Indiana |
| Authorized Official Name and Position | Khurrum a Shaikh (OWNER) |
| Authorized Official Contact | 2603444035 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primecare Clinic 6435 W Jefferson Blvd Pmb 109 Fort Wayne IN 46804-6203 Ph: (260) 344-4035 | Primecare Clinic 14417 Illinois Rd. Ste B Fort Wayne IN 46814 Ph: (260) 344-4035 |
| NPI Number | 1578147724 |
|---|---|
| Provider Enumeration Date | 05/12/2021 |
| Last Update Date | 05/12/2021 |
| Certification Date | 04/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578147724 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207R00000X | Internal Medicine | () | Primary |
| 363A00000X | Physician Assistant | () | Secondary |
| 363L00000X | Nurse Practitioner | () | Secondary |
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