Healthcare Provider Details

I. General information

NPI: 1730234071
Provider Name (Legal Business Name): NORTHERN INDIANA NEONATAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3221 COVINGTON LAKE DR
FORT WAYNE IN
46804-2515
US

IV. Provider business mailing address

11234 MINNICH RD ATTN JO HOFFMAN
FORT WAYNE IN
46816-9737
US

V. Phone/Fax

Practice location:
  • Phone: 260-639-3795
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL A. BIEHL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 260-639-3795