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Individual

GARY A. HAMBEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

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 1, FORT WAYNE, IN 46825-1545
(260) 373-9728
(260) 458-5664

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01035039
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000087417
ANTHEM
IN
01
000000787561
ANTEHM
IN
05
0634540
OH
05
100203570
IN
01
110030671
RAILROAD
01
260690MMM
MEDICARE
IN
01
HA063511
MEDICARE
OH
01
P00783719
RAILROAD
IN
Enumeration date
01/19/2006
Last updated
11/02/2012
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