| Fort Wayne Medical Education Program | |
|
750 Broadway Suite 350 Fort Wayne IN 46802-1412 | |
| (260) 423-2675 | |
| (260) 423-6621 |
| Full Name | Fort Wayne Medical Education Program |
|---|---|
| Speciality | Family Medicine |
| Location | 750 Broadway, Fort Wayne, Indiana |
| Authorized Official Name and Position | Kimberly Harris (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 2604232682 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Wayne Medical Education Program 750 Broadway Suite 150 Fort Wayne IN 46802-1412 Ph: (260) 423-2682 | Fort Wayne Medical Education Program 750 Broadway Suite 350 Fort Wayne IN 46802-1412 Ph: (260) 423-2675 |
| NPI Number | 1184635153 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 04/20/2015 |
| Medicare PECOS PAC ID | 2860387933 |
|---|---|
| Medicare Enrollment ID | O20040218000034 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184635153 | NPI | - | NPPES |
| 100050650A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lisa Hatcher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932164621 PECOS PAC ID: 7810983947 Enrollment ID: I20040422001649 |
| Provider Name | Zachry L Waterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902842677 PECOS PAC ID: 9436106341 Enrollment ID: I20050404000246 |
| Provider Name | Aaron K Coray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487853230 PECOS PAC ID: 7517032717 Enrollment ID: I20080822000470 |
| Provider Name | Robert E Wilkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992749485 PECOS PAC ID: 6103951991 Enrollment ID: I20100318000424 |
| Provider Name | Steven C Schwieterman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154367340 PECOS PAC ID: 3971558099 Enrollment ID: I20100807000087 |
| Provider Name | Hector F Perez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952385866 PECOS PAC ID: 2961474945 Enrollment ID: I20111207000344 |
| Provider Name | Keith J Derickson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538480439 PECOS PAC ID: 4880845619 Enrollment ID: I20130724000656 |
| Provider Name | Sarah J Turner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609162676 PECOS PAC ID: 7416107024 Enrollment ID: I20131112001984 |
| Provider Name | David Furman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831548510 PECOS PAC ID: 2769773555 Enrollment ID: I20171010000083 |
| Provider Name | Aiwen Liu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225561798 PECOS PAC ID: 1557787959 Enrollment ID: I20200817000921 |
| Provider Name | Kimberly J Schelb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114456993 PECOS PAC ID: 3577832765 Enrollment ID: I20200827003072 |
| Provider Name | Townsen G Kennington |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1558981001 PECOS PAC ID: 6406258169 Enrollment ID: I20240927001201 |
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Northeast Medical Associates, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1234 E. Dupont Rd., Suite 6, Fort Wayne, IN 46825 Phone: 260-480-2600 Fax: 260-496-8077 | |
Anthony Medical Associates P C Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1330 N Coliseum Blvd, Fort Wayne, IN 46805 Phone: 260-447-8982 Fax: 260-447-4483 | |
Community Open Mri Of Auburn Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2428 Lake Ave, Fort Wayne, IN 46805 Phone: 260-422-1491 Fax: 260-423-1421 | |
Ashraf H. Hanna, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4306 Lake Avenue, Fort Wayne, IN 46815 Phone: 260-422-1906 Fax: 260-422-1925 | |
Act 3 Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7309 Trier Rd, Fort Wayne, IN 46815 Phone: 260-515-3275 | |
Bowen Health Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 201 E Rudisill Blvd, Fort Wayne, IN 46806 Phone: 800-342-5653 |