Mastbaum, Leonard I

Mastbaum, Leonard I is an individual health care provider with primary practice located at 11123 Parkview Plaza Dr Suite 202, Fort Wayne IN 46845-1707. He recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as his primary health care specialty. Mastbaum, Leonard I can be contacted via phone (260) 373-4280.

Contact Information

Primary practice address
11123 Parkview Plaza Dr Suite 202 Fort Wayne IN 46845-1707
Phone: (260) 373-4280
Fax: (260) 373-4288
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 01041346 Indiana

Profile Details

NPI number 1619928249
LBN Legal business name Mastbaum, Leonard I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Mar 23rd, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619928249 NPPES
Indiana MEDICAID 100360850
Indiana Other 000000606758

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