Individual
DR. MARLONA KAY HARTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1717 S CALHOUN ST, FORT WAYNE, IN 46802-5257
(260) 458-2641
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
02002211A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000595576
ANTHEM
IN
05
—
200231200A
—
IN
01
—
7584345
AETNA
IN
01
—
P00698436
RAILROAD MEDICARE
IN
Enumeration date
08/20/2006
Last updated
05/14/2019
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