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Individual

REBECCA I. CASE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3909 NEW VISION DR, FORT WAYNE, IN 46845
(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
207Q00000X
Family Medicine Physician
Primary
01059698A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000346262
ANTHEM
IN
01
000000570552
ANTHEM
IN
01
15709
PHYSICIANS HEALTH PLAN
IN
05
200499120
IN
01
3937240008
MEDICARE DMEPOS
IN
01
4282045
AETNA
01
P00187398
RAILROAD MEDICARE
IN
Enumeration date
12/07/2005
Last updated
05/05/2023
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