Individual
MATTHEW W BEUCHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 436-8686
(260) 436-8585
Mailing address
PO BOX 2526, FORT WAYNE, IN 46801-2526
(260) 436-8686
(260) 436-8585
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01075091A
IN
207X00000X
Orthopaedic Surgery Physician
MD60440572
WA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
01075091A
IN
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
MD60440572
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000939417
ANTHEM
IN
01
—
000000939417
ANTHEM
—
05
—
0135798
—
OH
05
—
1306075742
—
WA
05
—
201289140
—
IN
Enumeration date
07/07/2009
Last updated
11/03/2016
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