Individual
T ERIC WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11108 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1730
(260) 266-5700
(260) 266-5920
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01039744A
IN
207RI0011X
Interventional Cardiology Physician
Primary
01039744A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000641099
ANTHEM
IN
01
—
060070589
RR MEDICARE
IN
01
—
060071113
RR MEDICARE
OH
01
—
06552
MEDICAID OH PARAMOUNT
OH
05
—
200074390
—
IN
01
—
P00825392
R.R. MEDICARE
IN
01
—
P00846099
MEDICARE RAILROAD
OH
Enumeration date
08/17/2005
Last updated
06/03/2025
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