Individual
EMMANUEL C. CABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7980 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4170
(260) 436-6765
(260) 436-7836
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3516
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01040740A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091880
BLUE CROSS BLUE SHIELD
—
05
—
100318020
—
IN
Enumeration date
11/02/2005
Last updated
09/24/2020
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