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VATCHE A ISRABIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11104 PARKVIEW CIRCLE DR STE 410, FORT WAYNE, IN 46845-0025
(260) 266-7856
(260) 266-5279
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
01040196
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000576545
ANTHEM
IN
01
000000670347
ANTHEM
IN
05
200148740
IN
01
P00790184
R.R. MEDICARE
IN
Enumeration date
05/15/2006
Last updated
10/07/2022
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