Organization
FORT WAYNE MEDICAL ONCOLOGY AND HEMATOLOGY, INC.
Active
Parent organization
FORT WAYNE MEDICAL ONCOLOGY AND HEMATOLOGY
Organization subpart
Yes
Provider details
NPI number
Legal business name
FORT WAYNE MEDICAL ONCOLOGY AND HEMATOLOGY
Authorized official
ANNE KRAHN (PRACTICE MANAGER)
(260) 969-7868
Entity
Organization
Contact information
Practice address
516 E MAUMEE ST, ANGOLA, IN 46703-2017
(260) 668-4040
(260) 668-3897
Mailing address
PO BOX 15099, FORT WAYNE, IN 46885-5099
(260) 484-8830
(260) 483-1911
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA4536
MEDICARE RR
IN
Enumeration date
12/16/2005
Last updated
10/11/2007
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