Individual
MR. MICHAEL THOMAS MUNGOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4705 ILLINOIS RD STE 102, FORT WAYNE, IN 46804-5108
(260) 447-1067
(260) 447-0827
Mailing address
4705 ILLINOIS RD, SUITE 102, FORT WAYNE, IN 46804-5114
(260) 447-1067
(260) 447-0827
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001044
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000343299
ANTHEM BCBS
KY
01
—
226000A
MEDICARE PTAN
IN
01
—
P00311763
RR MEDICARE
IN
Enumeration date
10/06/2006
Last updated
05/29/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us