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Individual

DR. ROBERT WAYNE DETTMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2935 AMBLESIDE WAY, FORT WAYNE, IN 46804-2443
(260) 459-7657
(260) 459-7658
Mailing address
2935 AMBLESIDE WAY, FORT WAYNE, IN 46804-2443
(260) 459-7657
(260) 459-7658

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01022140A
IN

Other

Enumeration date
01/18/2012
Last updated
01/18/2012
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