Organization
PULMONARY ASTHMA & ALLERGY CONSULTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PUSHPOM JAMES MD (MEDICAL DOCTOR)
(260) 489-6969
Entity
Organization
Contact information
Practice address
2510 E DUPONT RD, STE 200, FORT WAYNE, IN 46825
(260) 489-6969
(260) 490-3939
Mailing address
2510 E DUPONT RD, STE 200, FORT WAYNE, IN 46825
(260) 489-6969
(260) 490-3939
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
2080P0201X
Pediatric Allergy/Immunology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200062630A
—
IN
Enumeration date
03/14/2006
Last updated
08/08/2007
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