Healthcare Provider Details

I. General information

NPI: 1992741698
Provider Name (Legal Business Name): ALLIED PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 01/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11141 PARKVIEW PLAZA DR SUITE 210
FORT WAYNE IN
46845-1701
US

IV. Provider business mailing address

11141 PARKVIEW PLAZA DR SUITE 210
FORT WAYNE IN
46845-1701
US

V. Phone/Fax

Practice location:
  • Phone: 260-484-0919
  • Fax: 260-483-3097
Mailing address:
  • Phone: 260-484-0919
  • Fax: 260-483-3097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA L. WELLMAN
Title or Position: ASSOCIATE
Credential: M.D.
Phone: 260-484-0919