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General NPI Number Information
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NPI Number | 1437322567
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Entity Type | Individual
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Provider Name | ERIC J. DJENGE MD
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Gender | Male
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 1941 VIRGINIA AVE
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City | CONNERSVILLE
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State | IN
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Zip | 47331-2833
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Country | US
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Telephone | 765-827-8873
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Fax | 765-827-7743
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Provider Business Mailing Address
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Address Line | 5785 N DELAWARE ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-2527
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01068696A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01068696A
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License Number State | IN
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