Individual
CHRISTOPHER M WING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3707 NEW VISION DR, FORT WAYNE, IN 46845-1702
(260) 471-9466
(260) 484-5919
Mailing address
3707 NEW VISION DR, FORT WAYNE, IN 46845-1702
(260) 471-9466
(260) 484-5919
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01046594
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000092602
ANTHEM
IN
05
—
200147260
—
IN
05
—
2100587
—
OH
05
—
4074970100
—
MI
01
—
7991
PHP
IN
Enumeration date
05/23/2006
Last updated
01/27/2016
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