Individual
DR. NDA BUKHOSI MHLOPHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804
(260) 203-9600
(260) 407-8006
Mailing address
822 EAGLE HILL DR, APT B, INDIANAPOLIS, IN 46224-7182
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01080160A
IN
207P00000X
Emergency Medicine Physician
35.139172
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300014296
—
IN
Enumeration date
06/24/2015
Last updated
10/03/2022
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