Individual
TAMERA LYN VANDEGRIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2485 E WABASH ST, FRANKFORT, IN 46041-9400
(765) 659-7400
(765) 659-7408
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3513
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01057931A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200449770
—
IN
Enumeration date
04/04/2006
Last updated
02/19/2025
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