Kori De Graf, Adriana A
Kori De Graf, Adriana A is an individual health care provider with primary practice located at 11109 Parkview Plaza Dr , Fort Wayne IN 46845-1701. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Kori De Graf, Adriana A can be contacted via phone (260) 425-6780.Contact Information
Primary practice address
11109 Parkview Plaza Dr
Fort Wayne IN 46845-1701
Phone: (260) 425-6780
Fax: (260) 425-6615
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 45777 | Wisconsin |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 01077691A | Indiana |
Profile Details
| NPI number | 1962453704 |
|---|---|
| LBN Legal business name | Kori De Graf, Adriana A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 15th, 2006 |
| Last updated | Jul 6th, 2021 - 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 | 1962453704 | NPPES |
| Other | 000030377C | HUMANA | |
| MEDICAID | 34393000 | HUMANA |
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