Individual
REENA THAPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11104 PARKVIEW CIRCLE DR STE 20, FORT WAYNE, IN 46845-1733
(260) 425-6940
(260) 425-6949
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01070825A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000765825
ANTHEM
IN
05
—
201062690
—
IN
Enumeration date
08/31/2009
Last updated
11/15/2022
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