Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | 01081530A | IN |
Y | 2086S0127X | Trauma Surgeon | 01081530A | IN |
NPI | 1427255033 |
---|---|
Provider Name | Dr. Karen Rae O'bosky |
First Address | Fort Wayne, IN 46804-7934 |
Second Address | Fort Wayne, IN 46804-4128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 30/09/2020 |