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NPI Code Detail

MEDICARE: DR. SEAN M. GARREAN M.D.

MEDICARE: DR. SEAN M. GARREAN M.D.
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
1208600000XSurgery Physician036115199IL
2208C00000XColon & Rectal Surgery Physician01069614AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000714660OTHERINANTHEM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942459664
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SEAN M. GARREAN M.D.
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 : 306 E MAUMEE ST STE 201
Second Line :
City : ANGOLA
State : IN
Zip : 46703-2035
Country : US
Telephone Number : 260-266-5300
Fax Number : 260-266-5314
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2008
Last Update Date : 10/20/2022

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