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NPI Code Detail

MEDICARE: MR. BRET D KUEBER M.D.

MEDICARE: MR. BRET D KUEBER 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
1207Q00000XFamily Medicine Physician01061176AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00244632OTHERINRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922078062
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRET D KUEBER M.D.
Provider Business Mailing Address
First Line : 3702 NEW VISION DR BLDG B
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1703
Country : US
Telephone Number : 260-266-8207
Fax Number :
Provider Business Practice Location Address
First Line : 128 N. RANDOLPH STREET
Second Line :
City : GARRETT
State : IN
Zip : 46738-1138
Country : US
Telephone Number : 260-357-6557
Fax Number : 260-357-0373
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2006
Last Update Date : 10/17/2022

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Directions to “ MR. BRET D KUEBER M.D.” Practice Location

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