Individual
KATHY BACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2231 CAREW ST, FORT WAYNE, IN 46805-4713
(260) 373-7765
Mailing address
2231 CAREW ST, FORT WAYNE, IN 46805-4713
(260) 373-7765
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
11023184A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2022
Last updated
02/28/2025
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