Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | AH4337526-443 | MI |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 01077591A | IN |
NPI | 1083820286 |
---|---|
Provider Name | Dr. Dona Mirela Uncheselu |
First Address | Fort Wayne, IN 46845-1712 |
Second Address | Fort Wayne, IN 46845-1701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 17/03/2017 |