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Individual

DANA R FORREST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2516 E DUPONT RD, FORT WAYNE, IN 46825-1608
(260) 458-3740
(260) 458-3741
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3516
(260) 479-3520

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01060919A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01060919
STATE LICENSE
IN
05
200824170 A
IN
01
7622997
AETNA
IN
Enumeration date
07/12/2006
Last updated
03/07/2023
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