Individual
DR. MICHAEL JAMES BANGERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MICHAEL BANGERT, OD
Contact information
Practice address
4626 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6826
(260) 432-5502
(260) 432-8415
Mailing address
4626 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6826
(260) 432-5502
(260) 432-8415
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001776B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410005869
RETIRED RAILROAD MEDICARE
IN
Enumeration date
01/26/2007
Last updated
07/30/2013
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