Organization · Type 2 NPI
Regen Med of Indiana LLC
General Practice Physician · Fort Wayne, IN
NPI number
1104395680
Active
Practice location
5931 Stoney Creek Dr
Fort Wayne, IN 46825-4401
Fax (260) 483-3964
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | None listed |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
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About NPI 1104395680
Regen Med of Indiana LLC's National Provider Identifier is 1104395680, issued on Nov 14, 2018. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Fort Wayne, IN. The record was last updated on Nov 14, 2018.