Individual
POOJA MODI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 672-6620
(260) 672-6639
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01084561A
IN
207R00000X
Internal Medicine Physician
4301112544
MI
207R00000X
Internal Medicine Physician
4351029322
MI
Other
Enumeration date
06/14/2017
Last updated
03/29/2023
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