Individual
BRAD EDWARD WARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 266-1000
(260) 482-4442
Mailing address
3640 NEW VISION DR STE A, FORT WAYNE, IN 46845-1717
(260) 482-4440
(260) 482-4442
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02004712A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000995809
ANTHEM
IN
05
—
0178315
—
OH
05
—
201338120
—
IN
Enumeration date
05/03/2013
Last updated
11/13/2018
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