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NPI Code Detail

MEDICARE: DUANE M WAMPLER PA-C

MEDICARE: DUANE M WAMPLER PA-C
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
1363AS0400XSurgical Physician Assistant10000266AIN

General Provider Information

NPI Number : 1154312122
Entity Type Code : Individual
Provider Name (Legal Business Name) : DUANE M WAMPLER PA-C
Provider Business Mailing Address
First Line : 1802 DAY RD
Second Line :
City : MISHAWAKA
State : IN
Zip : 46545-4329
Country : US
Telephone Number : 574-204-7200
Fax Number : 574-252-0633
Provider Business Practice Location Address
First Line : 7881 CARNEGIE BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-5792
Country : US
Telephone Number : 260-436-8000
Fax Number : 260-436-0929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 07/10/2025

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Directions to “ DUANE M WAMPLER PA-C” Practice Location

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