Individual
SIMHACHALAM GURUGUBELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
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
01092805A
IN
207R00000X
Internal Medicine Physician
29092
MS
207R00000X
Internal Medicine Physician
4301116161
MI
208M00000X
Hospitalist Physician
29092
MS
Other
Enumeration date
07/02/2018
Last updated
09/03/2024
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