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NPI Code Detail

MEDICARE: KENAN ALIBEGOVIC DO

MEDICARE:   KENAN  ALIBEGOVIC  DO
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 Physician02006464AIN

General Provider Information

NPI Number : 1285258053
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENAN ALIBEGOVIC DO
Provider Business Mailing Address
First Line : 11109 PARKVIEW PLAZA DR # 117
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8607 TEMPLE DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46809-3048
Country : US
Telephone Number : 260-478-9220
Fax Number : 260-478-9172
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2020
Last Update Date : 08/30/2023

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Directions to “ KENAN ALIBEGOVIC DO” Practice Location

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