Individual
JOHN W. FEHRENBACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1801 SENATE BLVD, SUITE 755, INDIANAPOLIS, IN 46202-1228
(317) 923-1787
(317) 583-7601
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01026519A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100327040
—
IN
01
—
P00632723
RAILROAD MEDICARE
IN
Enumeration date
07/18/2006
Last updated
01/30/2014
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