Individual
FRED L. RASP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7952 W JEFFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 435-2836
(260) 435-7585
Mailing address
6920 POINTE INVERNESS WAY STE 200, MEDPARTNERS, ATTN: MEGAN FORTNEY, FORT WAYNE, IN 46804-7934
(260) 479-3515
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01024370A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000087415
ANTHEM
IN
05
—
0624739
—
OH
05
—
100355530
—
IN
01
—
P00783794
RAILROAD MEDICARE
IN
Enumeration date
03/01/2006
Last updated
01/19/2017
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