Menon, Mohan M
Menon, Mohan M is an individual health care provider with primary practice located at 3030 Lake Ave Suite 27, Fort Wayne IN 46805-5428. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Menon, Mohan M can be contacted via phone (260) 422-5569.Contact Information
Primary practice address
3030 Lake Ave Suite 27
Fort Wayne IN 46805-5428
Phone: (260) 422-5569
Fax: (260) 422-6086
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 01028503A | Indiana |
Profile Details
| NPI number | 1851491377 |
|---|---|
| LBN Legal business name | Menon, Mohan M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 24th, 2006 |
| Last updated | Aug 13th, 2012 - about 13 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 | 1851491377 | NPPES |
| Indiana | MEDICAID | 100054450 |
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