Organization
EMERGENCY PHYSICIANS OF INDIANA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WAGEL MD (PRESIDENT)
(800) 925-4600
Entity
Organization
Contact information
Practice address
1316 E 7TH ST, AUBURN, IN 46706-2523
(800) 925-4600
Mailing address
10351 DAWSONS CREEK BLVD, STE D, FORT WAYNE, IN 46825-1904
(260) 969-1950
(260) 918-2137
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200336930A
—
IN
01
—
CH7804
RAILROAD MEDICARE
IN
Enumeration date
05/18/2006
Last updated
09/11/2014
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