# NORTHEAST REGIONAL FAMILY PRACTICE P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** W David Pepple MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154382729
- **Authorized official:** WALTER DAVID PEPPLE MD (PRESIDENT)
- **Authorized official phone:** (260) 422-8770

## Contact information

- **Practice address:** 10327 DAWSONS CREEK BLVD 9 D, WAYNE, IN 46825
- **Practice address phone:** (260) 424-8770
- **Practice address fax:** (260) 469-8774
- **Mailing address:** 10327 DAWSONS CREEK BLVD 9 D, WAYNE, IN 46825
- **Mailing address phone:** (260) 424-8770
- **Mailing address fax:** (260) 469-8774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01023389 | IN | Yes |

## Other

- **Enumeration date:** 03/31/2006
- **Last updated:** 07/15/2014