Individual
JEHANGIR ANWAR ANSARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 266-2020
Mailing address
3702 NEW VISION DR BLDG B, FORT WAYNE, IN 46845-1703
(260) 266-6013
(260) 458-5831
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01078921A
IN
207R00000X
Internal Medicine Physician
2017030891
MO
208M00000X
Hospitalist Physician
2017030891
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0104139
—
OH
Enumeration date
03/20/2011
Last updated
12/06/2021
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