Fort Wayne Medical Clinic PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01059980A Issued in IN

Legal business name

FORT WAYNE MEDICAL CLINIC PC

Practice address

3537 N Anthony Blvd Ste C
Fort Wayne, IN 46805-1423

Phone

(260) 471-5777

Fax

(260) 739-3927

NPI assigned

Aug 23, 2013

Last updated

Aug 23, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Syed M. Sohail, M.D.NPI 1053523910

Title

Owner/Provider

Phone

(260) 471-5777

Specialties & licenses 1

Addresses

Other names 1

• Fort Wayne Occupational Medical Clinic PC Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Syed Sohail, M.D.MPH.MBA

  • Geriatric Medicine (Internal Medicine) Physician
  • Fort Wayne, IN
  • NPI 1053523910
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377216000000",
    "number": "1043644354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3537 N ANTHONY BLVD STE C",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051423",
            "telephone_number": "260-471-5777",
            "fax_number": "260-739-3927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3537 N ANTHONY BLVD STE C",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051423",
            "telephone_number": "260-471-5777",
            "fax_number": "260-739-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-23",
        "last_updated": "2013-08-23",
        "status": "A",
        "authorized_official_last_name": "SOHAIL",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "260-471-5777",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01059980A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Wayne Occupational Medical Clinic PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Fort Wayne Medical Institute
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• Internal Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.