MEDICARE: RUDY A. KACHMANN 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	207T00000X	Neurological Surgery Physician	01019778A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	140001923	OTHER	IN	RR MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1104823590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUDY A. KACHMANN M.D.

Provider Business Mailing Address
First Line	:	7900 W JEFFERSON BLVD STE 201
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-4128
Country	:	US
Telephone Number	:	260-432-2297
Fax Number	:	260-434-6420

Provider Business Practice Location Address
First Line	:	7900 W JEFFERSON BLVD STE 201
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-4128
Country	:	US
Telephone Number	:	260-432-2297
Fax Number	:	260-434-6420

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	08/14/2013

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Directions to “ RUDY A. KACHMANN M.D.” Practice Location

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