| Mastbaum Endocrinology | |
|
7950 W Jefferson Blvd Fort Wayne IN 46804-4140 | |
| (260) 435-7001 | |
| (260) 969-7101 |
| Full Name | Mastbaum Endocrinology |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 7950 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Jodie Hattery (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2609697173 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mastbaum Endocrinology 7900 W Jefferson Blvd Suite 201 Fort Wayne IN 46804-4128 Ph: (260) 969-7100 | Mastbaum Endocrinology 7950 W Jefferson Blvd Fort Wayne IN 46804-4140 Ph: (260) 435-7001 |
| NPI Number | 1285892752 |
|---|---|
| Provider Enumeration Date | 05/30/2008 |
| Last Update Date | 05/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285892752 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 01041346 (Indiana) | Primary |
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