Individual
MR. JASPREET S JAWANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1660 BROADWAY STE 165, FORT WAYNE, IN 46802-4377
(260) 266-9805
(260) 266-9815
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01078217A
IN
207Q00000X
Family Medicine Physician
Primary
01078217A
IN
207Q00000X
Family Medicine Physician
MT207428
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001080493
ANTHEM
IN
05
—
300001591
—
IN
Enumeration date
06/20/2014
Last updated
04/11/2023
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