MEDICARE: DR. DALE HILMER AESCHLIMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	01025296A	IN

General Provider Information

NPI Number	:	1902894173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DALE HILMER AESCHLIMAN M.D.

Provider Business Mailing Address
First Line	:	5717 S ANTHONY BLVD
Second Line	:	SUITE 600
City	:	FORT WAYNE
State	:	IN
Zip	:	46806-3386
Country	:	US
Telephone Number	:	260-441-3253
Fax Number	:	260-441-3214

Provider Business Practice Location Address
First Line	:	5717 S ANTHONY BLVD
Second Line	:	SUITE 600
City	:	FORT WAYNE
State	:	IN
Zip	:	46806-3386
Country	:	US
Telephone Number	:	260-441-3253
Fax Number	:	260-441-3214

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	12/05/2007

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