Bultemeyer, Marlene Clare
Bultemeyer, Marlene Clare is an individual health care provider with primary practice located at 7956 W Jefferson Blvd , Fort Wayne IN 46804-4140. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Bultemeyer, Marlene Clare can be contacted via phone (260) 436-2416.Contact Information
Primary practice address
7956 W Jefferson Blvd
Fort Wayne IN 46804-4140
Phone: (260) 436-2416
Fax: (260) 436-9662
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 01066634A | Indiana |
Profile Details
| NPI number | 1083828719 |
|---|---|
| LBN Legal business name | Bultemeyer, Marlene Clare |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 10th, 2007 |
| Last updated | Aug 1st, 2023 - about 2 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 | 1083828719 | NPPES |
| Michigan | MEDICAID | 1083828719 | |
| Michigan | MEDICAID | 3034657 | |
| Michigan | MEDICAID | 200974740 |
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