Individual
DR. HEATHER ELIZABETH EASTERDAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Mailing address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01068073
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000656255
ANTHEM
IN
05
—
200981590
—
IN
Enumeration date
05/09/2007
Last updated
01/24/2024
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