Individual
SADAF BANGASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
410 N SAWYER RD, KENDALLVILLE, IN 46755-2572
(260) 347-0977
(260) 347-8547
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01060392A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000362585
ANTHEM
IN
01
—
000000570553
ANTHEM
IN
01
—
17796
PHYSICIANS HEALTH PLAN
IN
05
—
200515640
—
IN
01
—
3937240001
MEDICARE DMEPOS
IN
01
—
7911687
AETNA
—
01
—
P00226337
RAILROAD MEDICARE
IN
Enumeration date
12/05/2005
Last updated
10/17/2022
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