Individual
RONALD L. SARRAZINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11123 PARKVIEW PLAZA DR, STE. 106, FORT WAYNE, IN 46845-1707
(260) 672-6550
(260) 672-6559
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01049006A
IN
208000000X
Pediatrics Physician
01049006A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000200321
ANTHEM
IN
01
—
000000206998
ANTHEM
IN
01
—
000000244846
ANTHEM
IN
01
—
00002092734 02
UNITED HEALTHCARE
—
01
—
12183
PHYSICIANS HEALTH PLAN
IN
05
—
200342320
—
IN
01
—
3937240021
MEDICARE DMEPOS
IN
01
—
7413303
AETNA
—
Enumeration date
12/28/2005
Last updated
11/29/2022
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