Individual
ASHISH KUMAR KHEMKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
(260) 460-1425
Mailing address
2103 BRAEMAR DR, FORT WAYNE, IN 46814-9370
(260) 625-5618
(260) 460-1425
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01041022
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100094690-A
—
IN
Enumeration date
08/11/2006
Last updated
07/08/2007
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