SYED R. MUMTAZ


Address: 909 E State Blvd, Fort Wayne, IN 46805-3404
Phone: 2604812700

SYED R. MUMTAZ (NPI# 1396718573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396718573
Entity Type Individual
Full Name SYED R. MUMTAZ
Credential M.D.
Practice Address 909 E State Blvd
Fort Wayne
IN 46805-3404
Practice Telephone 2604812700
Practice Fax Number 2604812717
Mailing Telephone 2604812700
Mailing Fax Number 2604812717
Enumeration Date 2006-02-09
Last Update Date 2012-04-23
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084P0804X Psychiatry & Neurology
Specialization: Child & Adolescent Psychiatry
01049582A IN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IN 200224110 05

Other Providers SYED MUMTAZ

NPI Name Taxonomy Address Enumeration
1053346148 Syed T Mumtaz Specialist 724 W Vine St, Kissimmee, FL 34741-4161 2006-07-11
1902995798 Syed Shahid Mumtaz Psychiatry & Neurology 2615 Edwards St, Alton, IL 62002-3915 2006-10-12

Office Location

Street Address 909 E STATE BLVD
City FORT WAYNE
State IN
Zip Code 46805-3404

Providers in the same location

NPI Name Taxonomy Address Enumeration
1689664419 Richard A Horstmeyer Family Medicine 909 E State Blvd, Fort Wayne, IN 46805-3404 2005-10-24
1174132674 Rachel Lee Taykowski Social Worker 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-07-30
1831708510 Alexandra Leroy Counselor 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-07-28
1881203560 Timothy James Prentice Counselor 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-07-28
1922617620 Elise S. Beech Social Worker 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-07-28
1457972481 David D Hibish Case Manager/Care Coordinator 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-04-30
1790317667 Jill Elizabeth Surine Counselor 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-02-10
1851923627 Emily Redman Counselor 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-02-10
1912537325 Estrella Devia Case Manager/Care Coordinator 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-01-24
1083252548 Amber Ginet O'daniels Counselor 909 E State Blvd, Fort Wayne, IN 46805-3458 2019-12-16
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1619589546 Connor Gemlick Student in an Organized Health Care Education/Training Program 1918 Carew St., Fort Wayne, IN 46805 2020-08-21
1710464086 S.t.a.r. Care Services Clinic/Center 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 2018-07-19
1083122865 Noel Shafi Counselor 3010 East State Boulevard, Fort Wayne, IN 46805 2018-01-16
1063963627 Toni L Irby Specialist 3219 E State Blvd, Fort Wayne, IN 46805 2016-10-19
1639626211 Logan Schwerer Pharmacist 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 2016-09-01
1063817104 Michale Diane Rothgeb Physical Therapy Assistant 2200 Randollia Dr, Fort Wayne, IN 46805 2014-10-31
1124435789 Julia I. Mcfann Physical Therapist 2200 Randalia Dr, Fort Wayne, IN 46805 2014-07-16
1083036974 Capital Senior Living Properties 4, Inc. Assisted Living Facility 3320 East State Boulevard, Fort Wayne, IN 46805 2014-01-10
1356772396 Alexander James Medical Supply Durable Medical Equipment & Medical Supplies 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 2013-12-02
1043595689 Randy James Jennings Pharmacist 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 2011-10-14
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Taxonomy Information

Taxonomy Code 2084P0804X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Child & Adolescent Psychiatry

Taxonomy Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1326458514 Ambreen Khan Ghori Psychiatry & Neurology 2100 Goshen Rd, Fort Wayne, IN 46808-1493 2014-04-28

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1659695278 Harmony Medical Associates LLC Psychiatry & Neurology 11837 Wedgeport Ln, Fishers, IN 46037-7987 2010-03-25
1508046624 Kearn D Hinchman D O Inc Psychiatry & Neurology 53779 Generations Dr Ste 1, South Bend, IN 46635-1576 2007-11-06
1144337791 Benjamin Louis Troy Psychiatry & Neurology 230 East Day Road, Suite 160, Mishawaka, IN 46545-3463 2006-08-23
1770526618 Elizabeth A Taylor Psychiatry & Neurology 3055 N Lake Ct, Newburgh, IN 47630 2006-06-14
1407807746 Syed J Khan Psychiatry & Neurology 10765 Lantern Road, Suite 102, Fishers, IN 46038-3597 2006-05-12
1821060294 Michael Welling Psychiatry & Neurology 2040 Shadeland Ave, Ste 200, Indianapolis, IN 46219-1734 2006-02-01
1184616294 Fadia T Aldahan Psychiatry & Neurology 5502 East 16th Street, Suite A21, Indianapolis, IN 46218-4932 2005-08-16
1700337920 Kledzik Psychiatric LLC Psychiatry & Neurology 9245 N Meridian St, 225, Indianapolis, IN 46260-1836 2016-10-24
1255714390 Ahmed Montaser Psychiatry & Neurology 121 Buntin St, Vincennes, IN 47591-1320 2015-07-07
1215334008 Mind Md LLC Psychiatry & Neurology 833 Park East Blvd, Lafayette, IN 47905-0785 2014-11-24
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Competitor

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City FORT WAYNE
Zip Code 46805

Improve Information

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Dataset Information

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.

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