Individual
MICHAEL S. MOHRMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1717 S CALHOUN ST, FORT WAYNE, IN 46802
(260) 478-5140
(260) 478-5145
Mailing address
1717 S CALHOUN ST, FORT WAYNE, IN 46802-5257
(260) 458-2641
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01027124A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000829
MPLAN
—
01
—
000000091878
BLUE CROSS BLUE SHIELD
—
01
—
080121950
RAILROAD MEDICARE
IN
05
—
100318070
—
IN
01
—
1610
PHYSICIANS HEALTH PLAN
—
Enumeration date
11/04/2005
Last updated
07/05/2018
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