Individual
DAVID J. PARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7980 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4170
(260) 478-5280
(260) 458-3536
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3516
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01039725A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000832
MPLAN
—
01
—
000000091885
BLUE CROSS BLUE SHIELD
—
01
—
080121953
RAILROAD MEDICARE
IN
05
—
100318120
—
IN
01
—
1672
PHYSICIANS HEALTH PLAN
—
Enumeration date
11/04/2005
Last updated
10/14/2020
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