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ALLIED PHYSICIANS INC

Clinical Neuropsychologist

Fort Wayne, Indiana

Provider NPI: 1205098100

Organization Information:
Organization Name:  ALLIED PHYSICIANS INC
Organization is not Subpart
Authorized Official:  ISA S CANAVATI  PRESIDENT  260-4362416

Practice Location:
7956 W JEFFERSON BLVD  FORT WAYNE, IN 46804 US
Tel: 260-436-2416  Fax: --

Business Mailing Address:
7956 W JEFFERSON BLVD  FORT WAYNE, IN 46804 US
Tel: 260-436-2416  Fax: --

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
N1041C0700XBehavioral Health & Social Service Providers
Social Worker
N208100000XPhysicians
Physical Medicine & Rehabilitation
N2084N0400XPhysicians
Psychiatry & Neurology
N363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
N363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Y207T00000XPhysicians
Neurological Surgery

Other Provider Identifiers:

IssuerNumberStateType
0515955OH05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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