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NPI Code Detail

MEDICARE: DANIEL JOHN ANDERSEN DO

MEDICARE: DANIEL JOHN ANDERSEN 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
1207X00000XOrthopaedic Surgery Physician02008280AIN

General Provider Information

NPI Number : 1841856515
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL JOHN ANDERSEN DO
Provider Business Mailing Address
First Line : 5052 N CLINTON ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-5822
Country : US
Telephone Number : 260-484-8551
Fax Number : 260-482-5060
Provider Business Practice Location Address
First Line : 5050 N CLINTON ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-5886
Country : US
Telephone Number : 260-484-8551
Fax Number : 260-482-5060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2019
Last Update Date : 03/02/2026

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