Individual
JOHN S. MOHRMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1717 S CALHOUN ST, FORT WAYNE, IN 46802-5257
(260) 458-2641
Mailing address
1717 S CALHOUN ST, FORT WAYNE, IN 46802-5257
(260) 458-2641
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01027547A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091881
BLUE CROSS BLUE SHIELD
—
05
—
100318060
—
IN
01
—
P00952928
RAILROAD MEDICARE
IN
Enumeration date
11/04/2005
Last updated
06/25/2021
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