Organization
PROFESSIONAL EMERGENCY PHYSICIANS PC
Active
Organization
PROFESSIONAL EMERGENCY PHYSICIANS PC
Active
Other names
Professional Emergency Physicians Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS E GUTWEIN MD (PRESIDENT)
(260) 482-4440
Entity
Organization
Contact information
Practice address
2200 RANDALLIA DRIVE, FORT WAYNE, IN 46805-4638
(260) 373-4000
(260) 482-4442
Mailing address
608 UNION CHAPEL RD, FORT WAYNE, IN 46845-9357
(260) 482-4440
(260) 482-4442
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000101129
ANTHEM
IN
01
—
047840
MEDICARE CMS
IN
05
—
0882335
—
OH
05
—
100050250 H
—
IN
05
—
100050250 I
—
IN
05
—
100050250 J
—
IN
05
—
100050250A
—
IN
05
—
100050250C
—
IN
05
—
100050250D
—
IN
05
—
100050250E
—
IN
05
—
100050250F
—
IN
Enumeration date
09/16/2005
Last updated
06/13/2025
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