Individual
DAVID EMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2200 RANDALLIA DR, FORT WAYNE, IN 46805-4638
(260) 373-6315
(260) 373-6348
Mailing address
1234 E DUPONT RD, SUITE 1, FORT WAYNE, IN 46825-1545
(260) 373-9700
(260) 373-9740
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
01033196
IN
207RP1001X
Pulmonary Disease Physician
01033196
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000525271
ANTHEM
IN
05
—
100143900
—
IN
01
—
3002075
OH MEDICAID
IN
01
—
5255071
AETNA
IN
01
—
P00465466
RAILROAD MEDICARE
IN
Enumeration date
07/24/2006
Last updated
03/20/2013
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