Individual
MICHAEL T ISENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7900 W JEFFERSON BLVD, SUITE 201, FORT WAYNE, IN 46804-4128
(260) 969-7100
(260) 969-7264
Mailing address
7900 W JEFFERSON BLVD, SUITE 201, FORT WAYNE, IN 46804-4128
(260) 969-7100
(260) 969-7264
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01024412A
IN
207RG0100X
Gastroenterology Physician
Primary
01024412
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100355800
—
IN
Enumeration date
05/18/2006
Last updated
08/12/2010
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