Individual
DALE A. SLOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7910 W JEFFERSON BLVD, SUITE 112, FORT WAYNE, IN 46804-4159
(260) 969-7121
(260) 479-4614
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3514
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01028999A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0655616
—
OH
05
—
100079890
—
IN
05
—
103410218
—
MI
01
—
P01216813
RAILROAD MEDICARE
IN
Enumeration date
08/04/2005
Last updated
07/11/2023
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