Individual
CHARLES TSAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
109 CHESTNUT HILLS PKWY, FORT WAYNE, IN 46814-8924
(260) 918-2971
(260) 918-1397
Mailing address
109 CHESTNUT HILLS PKWY, FORT WAYNE, IN 46814-8924
(260) 918-2971
(260) 918-1397
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01050530
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000092596
ANTHEM
IN
01
—
10485
PHP
IN
05
—
200224540
—
IN
05
—
2150505
—
OH
05
—
4115473100
—
MI
Enumeration date
05/22/2006
Last updated
07/08/2007
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