Individual
DAVID S. MOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3534 BROOKLYN AVE, FORT WAYNE, IN 46809-1361
(260) 478-5130
(260) 478-5133
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3516
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01073536A
IN
207R00000X
Internal Medicine Physician
01073536A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201214460
—
IN
Enumeration date
07/16/2010
Last updated
10/13/2020
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