Gendy, Mohamed G
Gendy, Mohamed G is an individual health care provider with primary practice located at 7802 W Jefferson Blvd Ste A , Fort Wayne IN 46804-4138. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Gendy, Mohamed G can be contacted via phone (260) 305-2822.Contact Information
Primary practice address
7802 W Jefferson Blvd Ste A
Fort Wayne IN 46804-4138
Phone: (260) 305-2822
Fax: (260) 305-2829
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 036137626 | Illinois |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 01088661A | Indiana |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 60540 | Wisconsin |
Profile Details
| NPI number | 1508183427 |
|---|---|
| LBN Legal business name | Gendy, Mohamed G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 2nd, 2010 |
| Last updated | Dec 1st, 2022 - about 3 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 | 1508183427 | NPPES |
| Indiana | MEDICAID | 300067629 | |
| Indiana | Other | IN5423002 | |
| Indiana | MEDICAID | 1508183427 |
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