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Individual

CYNTHIA L WELLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2200 RANDALLIA DR, FORT WAYNE, IN 46805
(260) 373-6070
(260) 373-6704
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
01039378A
IN
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
01039378A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0425810
OH
05
100378040A
IN
Enumeration date
08/09/2005
Last updated
10/07/2022
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