Individual
RAYMOND E DUSMAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1819 CAREW ST, FORT WAYNE, IN 46805-4705
(260) 481-4700
(260) 481-4808
Mailing address
1234 E. DUPONT RD., 3, FORT WAYNE, IN 46825-1545
(260) 373-9700
(260) 373-9740
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01033566A
IN
207RC0001X
Clinical Cardiac Electrophysiology Physician
01033566A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000641075
ANTHEM
IN
01
—
060070557
RR MEDICARE
IN
05
—
0783933
—
OH
05
—
100321280
—
IN
01
—
P00785633
R.R. MEDICARE
IN
Enumeration date
08/15/2005
Last updated
03/20/2013
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