Individual
DANA OBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3909 NEW VISION DR, FORT WAYNE, IN 46845-1725
(260) 469-6610
(260) 969-3065
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
28202609A
IN
363L00000X
Nurse Practitioner
Primary
71010048A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001385172
BCBS
IN
01
—
000001426774
BCBS
IN
01
—
000001427226
BCBS
IN
01
—
000001427228
BCBS
IN
01
—
000001427229
BCBS
IN
01
—
000001433160
BCBS
IN
05
—
300038710
—
IN
Enumeration date
05/15/2020
Last updated
02/06/2023
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