Fort Wayne Medical Education Program

NPI #1184635153 in Fort Wayne, Indiana

Provider Information

NPI Number: 1184635153
Entity Type: Organization
Organization Name: Fort Wayne Medical Education Program
Primary Specialty: Family Medicine
Enumeration Date: Aug 11, 2006
Last Updated: Apr 20, 2015

Practice Location

Address: 750 BROADWAY
Address 2: SUITE 350
City: Fort Wayne
State: Indiana
ZIP Code: 46802-1412
Phone: (260) 423-2675

Authorized Official

Name: KIMBERLY HARRIS, COO
Title: CHIEF OPERATING OFFICER
Phone: (260) 423-2682

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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