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Individual

LAWRENCE F. WUEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1331 MINNICH RD, NEW HAVEN, IN 46774-2051
(260) 425-5000
(260) 425-5048
Mailing address
3702 NEW VISION DR BLDG B, FORT WAYNE, IN 46845-1703

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01036902A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000111936
ANTHEM
IN
01
00000814257 07
UNITED HEALTHCARE
01
080130032
RAILROAD MEDICARE
IN
01
080140740
RAILROAD MEDICARE
IN
05
100081740
IN
01
2030
PHYSICIANS HEALTH PLAN
IN
01
3937240005
MEDICARE DMEPOS
IN
01
4207133
AETNA
Enumeration date
12/29/2005
Last updated
10/20/2022
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