Individual
FRED DOLORESCO II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11108 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1730
(260) 266-5700
(260) 266-5920
Mailing address
1234 E DUPONT RD, SUITE 1, FORT WAYNE, IN 46825-1545
(260) 373-7875
(260) 373-9705
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01033928A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000641073
ANTHEM
IN
05
—
0568952
—
OH
01
—
060070575
RR MEDICARE
IN
05
—
100146050
—
IN
01
—
P00793604
R.R. MEDICARE
IN
Enumeration date
08/15/2005
Last updated
09/23/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us