Desimone, James
Desimone, James is an individual health care provider with primary practice located at 3810 New Vision Dr , Fort Wayne IN 46845-1708. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Desimone, James can be contacted via phone (260) 482-1004.Contact Information
Primary practice address
3810 New Vision Dr
Fort Wayne IN 46845-1708
Phone: (260) 482-1004
Fax: (260) 483-7894
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 01045846A | Indiana |
Profile Details
| NPI number | 1427055771 |
|---|---|
| LBN Legal business name | Desimone, James |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 1st, 2005 |
| Last updated | Apr 9th, 2018 - about 6 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 | 1427055771 | NPPES |
| Indiana | Other | 000000082073 | ANTHEM BC/BS |
| Indiana | Other | 7152 | ANTHEM BC/BS |
| Indiana | MEDICAID | 200118610A | ANTHEM BC/BS |
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