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NPI Code Detail

MEDICARE: ESA SYED

MEDICARE: ESA SYED
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1386453298
Entity Type Code : Individual
Provider Name (Legal Business Name) : ESA SYED
Provider Business Mailing Address
First Line : 2200 RANDALLIA DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-4638
Country : US
Telephone Number : 260-373-7765
Fax Number :
Provider Business Practice Location Address
First Line : 2231 CAREW ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-4713
Country : US
Telephone Number : 260-373-7765
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2025
Last Update Date : 06/17/2026

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Directions to “ ESA SYED ” Practice Location

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