Individual provider · Type 1 NPI

Benjamin Jon Moreno, MD, PhD

Diagnostic Radiology Physician · Fort Wayne, IN

NPI number 1013163526 Active

Practice location

3707 New Vision Dr Ste 110
Fort Wayne, IN 46845-1702

Call (260) 469-6602 Map

Fax (260) 484-5919

Mailing address

3707 New Vision Dr
Fort Wayne, IN 46845-1702

Specialties and licenses

TaxonomyCodeLicense
Vascular & Interventional Radiology Physician 2085R0204X01070072 (IN)
Diagnostic Radiology Physician Primary 2085R0202X01070072 (IN)

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

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About NPI 1013163526

Benjamin Jon Moreno, MD, PhD's National Provider Identifier is 1013163526, issued on Aug 15, 2008. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Fort Wayne, IN. The record was last updated on Mar 5, 2021.