Doctor Name: | PREETI NANAK DEMBLA |
NPI Number: | 1346248051 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 39332 |
Business Practice Address: | 7950 W Jefferson Blvd Hospitalist Office Fort Wayne, IN - 468044140 |
Business Phone Number: | 2604347088 |
Business Fax Number: | 2604357394 |
Mailing Address: | 7916 W Jefferson Blvd, Attn: Rita Zeddis Credentialing Dept FORT WAYNE |
State: | IN |
Postal Code: | 468044140 |
Phone Number: | 2604346377 |
Fax Number: | 2604346389 |
NPI Enumeration Date: | 07/07/2005 |
NPI Last Update Date: | 02/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 39332 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |