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Individual

LISA M SCHOMOGYI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2510 E DUPONT RD, SUITE 210, FORT WAYNE, IN 46825-1600
(260) 969-2990
Mailing address
10351 DAWSONS CREEK BLVD, SUITE D, FORT WAYNE, IN 46825-1904
(260) 969-1950
(260) 969-0988

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01049376A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000031417
MPLAN PARKVIEW
01
000000379760
ANTHEM
IN
01
0670165
CIGNA
05
200190090
IN
01
203267938
INDIANA HEALTH NETWORK
01
9689
PHYSICIANS HEALTH PLAN
01
P00326116
RAILROAD MEDICARE
Enumeration date
01/23/2006
Last updated
02/02/2009
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