Individual
KEVIN KYLE KINDUELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 672-6620
(260) 672-6639
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01073820A
IN
207R00000X
Internal Medicine Physician
MD27548
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274395
—
OR
01
—
P00472722
RR MEDICARE
OR
Enumeration date
03/21/2007
Last updated
10/03/2022
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