Organization
EMERGENCY MEDICINE OF INDIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVE P HOUSE MD (PRESIDENT)
(260) 435-7937
Entity
Organization
Contact information
Practice address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 435-7001
(260) 407-8014
Mailing address
PO BOX 11849, FORT WAYNE, IN 46861-1849
(260) 435-7937
(260) 435-7933
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA6307
RAIL ROAD MEDICARE
IN
01
—
CM0041
RAIL ROAD
IN
Enumeration date
05/22/2006
Last updated
02/05/2009
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