Bormann, John Louis
Bormann, John Louis is an individual health care provider with primary practice located at 5001 Us Highway 30 W Ste D , Fort Wayne IN 46818-9701. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Bormann, John Louis can be contacted via phone (260) 432-1568.Contact Information
Primary practice address
5001 Us Highway 30 W Ste D
Fort Wayne IN 46818-9701
Phone: (260) 432-1568
Fax: (260) 432-4969
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 01042016 | Indiana |
Profile Details
NPI number | 1689645707 |
---|---|
LBN Legal business name | Bormann, John Louis |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 27th, 2006 |
Last updated | Jun 17th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1689645707 | NPPES |
Indiana | MEDICAID | 100333820 | |
Indiana | MEDICAID | 0959155 | |
Indiana | MEDICAID | 1689645707 |
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