Individual
DR. ROBERT A HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4402 E STATE BLVD, FORT WAYNE, IN 46815-6917
(260) 425-5500
(260) 425-5505
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01085774A
IN
207Q00000X
Family Medicine Physician
35-05-3793
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0681445
—
OH
01
—
341774347
TAX ID
OH
Enumeration date
08/12/2005
Last updated
10/14/2022
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