Wren, Ethan
Wren, Ethan is an sole proprietor health care provider with primary practice located at 100 Navarre Pl Ste 4440 , South Bend IN 46601-1171. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Wren, Ethan can be contacted via phone (574) 647-5300.Contact Information
Primary practice address
100 Navarre Pl Ste 4440
South Bend IN 46601-1171
Phone: (574) 647-5300
Fax: (574) 647-5305
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 02006816A | Indiana |
Profile Details
| NPI number | 1124487301 |
|---|---|
| LBN Legal business name | Wren, Ethan |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 17th, 2016 |
| Last updated | Apr 4th, 2024 - about last year |
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 | 1124487301 | NPPES |
| Indiana | MEDICAID | 300064588 |
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