Individual
ANDREANA L. HODGINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
7938 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 458-3575
(260) 458-3582
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3516
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02001455A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000206189
BLUE CROSS
—
05
—
200009240A
—
IN
Enumeration date
06/18/2006
Last updated
03/02/2023
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