Organization
ALLEN COUNTY CARDIOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAVEEN LAL MD (MANG. PARTNER)
(260) 423-1331
Entity
Organization
Contact information
Practice address
604 W. BERRY ST, FT WAYNE, IN 46802-2106
(260) 423-1331
(260) 422-1046
Mailing address
604 W. BERRY ST, FT WAYNE, IN 46802-2106
(260) 423-1331
(260) 422-1046
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01027373A
IN
207RC0000X
Cardiovascular Disease Physician
01045695A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
01050563A
IN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
01051517A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275642837
MOHANDAS NPI
IN
01
—
1548379191
AHUJA NIP
IN
01
—
1770692337
LAL NPI
IN
01
—
1922117571
LOPEZ NPI
IN
05
—
200108750A
—
IN
05
—
200237610A
—
IN
05
—
200350400
—
IN
05
—
200387750A
—
IN
Enumeration date
04/23/2007
Last updated
09/20/2012
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