DR. SRINIVASAN DEVANATHAN (NPI# 1104874452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104874452 |
Entity Type | Individual |
Full Name | DR. SRINIVASAN DEVANATHAN |
Credential | M.D. |
Practice Address |
8028 Carnegie Blvd. Suite 600 Fort Wayne IN 46804-5790 |
Mailing Address |
1234 E. Dupont Road Suite 3 Fort Wayne IN 46825-1545 |
Practice Telephone | 2609697100 |
Practice Fax Number | 2609697263 |
Mailing Telephone | 2603739700 |
Mailing Fax Number | 2603739740 |
Enumeration Date | 2006-05-05 |
Last Update Date | 2013-04-30 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
01059028A | IN | Allopathic & Osteopathic Physicians |
Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
01059028 | IN | Allopathic & Osteopathic Physicians |
N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
01059028A | IN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | ANTHEM | 000000670561 | 01 |
IN | 200481860 | 05 | |
IN | R.R. MEDICARE | P00867128 | 01 |
Street Address |
8028 CARNEGIE BLVD. SUITE 600 |
City | FORT WAYNE |
State | IN |
Zip Code | 46804-5790 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
Find all providers in zip 46804 |
Taxonomy Code | 207RP1001X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Pulmonary Disease |
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528265709 | Sleep Centers of Fort Wayne LLC | Internal Medicine | 7223 Engle Rd Ste 110, Fort Wayne, IN 46804-2239 | 2007-06-29 |
1497858666 | Thomandram Sekar, Md, PC | Internal Medicine | 2910 Lake Ave, Fort Wayne, IN 46805-5416 | 2006-09-06 |
1235183203 | Rami S Wali | Internal Medicine | 2510 E Dupont Rd Ste 108, Fort Wayne, IN 46825-1601 | 2006-05-22 |
1174575047 | John B Fouts | Internal Medicine | 1818 Carew St., Suite 110, Fort Wayne, IN 46805-4764 | 2006-05-17 |
1386183614 | Ahmed M Sharaan | Internal Medicine | 11104 Parkview Circle Dr Ste 410, Fort Wayne, IN 46845-0025 | 2017-02-20 |
1184010050 | Martin Engman | Internal Medicine | 5917 Hallowell Pl, Fort Wayne, IN 46815-6214 | 2015-04-08 |
1316386386 | Georges Debal | Internal Medicine | 11104 Parkview Circle Dr Ste 410, Fort Wayne, IN 46845 | 2013-06-22 |
1043567886 | Bharat Bajantri | Internal Medicine | 11104 Parkview Circle Dr Ste 410, Fort Wayne, IN 46845 | 2012-08-10 |
1245527803 | Fahim Zaman Khan | Internal Medicine | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2011-07-05 |
1831358597 | Jennifer Shaffer | Internal Medicine | 11104 Parkview Circle Dr, Suite 410, Fort Wayne, IN 46845-1730 | 2008-06-06 |
Find all providers in FORT WAYNE |
City | FORT WAYNE |
Zip Code | 46804 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.