Individual
DR. CARLA J BRUMBAUGH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3707 NEW VISION DR, FORT WAYNE, IN 46845-1702
(260) 471-9466
(260) 484-5919
Mailing address
PO BOX 5602, FORT WAYNE, IN 46895-5602
(260) 471-9466
(260) 484-5919
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01041267
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000092606
ANTHEM
IN
Enumeration date
05/12/2006
Last updated
07/08/2007
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