Individual
DR. MIROSLAW A FOLTYNIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
213 FAIRVIEW BLVD, KENDALLVILLE, IN 46755-2988
(260) 347-4900
(260) 347-4966
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
208600000X
Surgery Physician
Primary
01038834
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000605424
ANTHEM
IN
05
—
100190980
—
IN
01
—
P00717118
MEDICAIRE RAILROAD
IN
Enumeration date
11/14/2005
Last updated
03/20/2013
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