| Indiana Medical Associates, Llc | |
|
7900 W Jefferson Blvd Suite 201 Fort Wayne IN 46804-4128 | |
| (260) 969-7100 | |
| (260) 969-7101 |
| Full Name | Indiana Medical Associates, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7900 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Lowell Teska (CEO) |
| Authorized Official Contact | 2609697100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indiana Medical Associates, Llc 7900 W Jefferson Blvd Suite 201 Fort Wayne IN 46804-4128 Ph: (260) 969-7100 | Indiana Medical Associates, Llc 7900 W Jefferson Blvd Suite 201 Fort Wayne IN 46804-4128 Ph: (260) 969-7100 |
| NPI Number | 1780628545 |
|---|---|
| Provider Enumeration Date | 06/15/2006 |
| Last Update Date | 01/05/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780628545 | NPI | - | NPPES |
| 2042720 | Medicaid | OH | |
| 200190390 | Medicaid | IN | |
| 200250290 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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