Individual
SUDHEER K. MEESA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7916 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 432-2297
(260) 434-6481
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3514
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
01054242A
IN
207RS0012X
Sleep Medicine (Internal Medicine) Physician
01054242A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000193012
ANTHEM
IN
05
—
200328970
—
IN
05
—
2259827
—
OH
Enumeration date
03/01/2006
Last updated
09/29/2020
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