Individual
DAVID OBER MAGNANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
975 MEZZANINE DR, SUITE B, LAFAYETTE, IN 47905-8635
(765) 449-7564
(765) 807-7943
Mailing address
975 MEZZANINE DR STE B, LAFAYETTE, IN 47905-8635
(765) 449-7564
(765) 807-7943
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01045133A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000330023
ANTHEM PROVIDER NUMBER
IN
05
—
200084030
—
IN
01
—
P00111858
MEDICARE RAILROAD NUMBER
IN
Enumeration date
03/14/2006
Last updated
04/11/2023
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