Individual
DR. RESHMA R KHATRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10515 ILLINOIS RD, FORT WAYNE, IN 46814-9182
(260) 373-9200
(260) 373-9219
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01069809A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000732458
ANTHEM
IN
05
—
201033360
—
IN
Enumeration date
06/13/2007
Last updated
10/20/2022
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