Individual
RONALD J LANDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11108 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1730
(260) 266-5700
(260) 266-5920
Mailing address
1234 E DUPONT RD, SUITE 3, FORT WAYNE, IN 46825-1545
(260) 373-7875
(260) 373-9705
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01027533A
IN
207RC0001X
Clinical Cardiac Electrophysiology Physician
01027533A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000641090
ANTHEM
IN
01
—
060070572
RR MEDICARE
IN
05
—
0917584
—
OH
05
—
100341860
—
IN
01
—
P00786838
R.R. MEDICARE
IN
Enumeration date
08/15/2005
Last updated
09/23/2013
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