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NPI Code Detail

MEDICARE: EMMANUEL C. CABE MD

MEDICARE: EMMANUEL C. CABE MD
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
1207Q00000XFamily Medicine Physician01040740AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000091880OTHERBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215928791
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMANUEL C. CABE MD
Provider Business Mailing Address
First Line : 6920 POINTE INVERNESS WAY STE 200
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-7934
Country : US
Telephone Number : 260-479-3516
Fax Number : 260-479-3520
Provider Business Practice Location Address
First Line : 7980 W JEFFERSON BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-4170
Country : US
Telephone Number : 260-436-6765
Fax Number : 260-436-7836
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 09/24/2020

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