Northeast Indiana Colon Rectal Surgeons, P.C.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

Legal business name

NORTHEAST INDIANA COLON RECTAL SURGEONS, P.C.

Practice address

7910 W Jefferson Blvd
Suite 212
Fort Wayne, IN 46804-4159

Phone

(260) 489-8898

Fax

(260) 373-4695

NPI assigned

Oct 31, 2005

Organization subpart

No

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

Authorized official

Name

Paul J. Raiman, M.D.

Title

Owner/Practitioner

Phone

(260) 489-8898

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255322244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7910 W JEFFERSON BLVD",
            "address_2": "SUITE 212",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044159",
            "telephone_number": "260-489-8898",
            "fax_number": "260-373-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 W JEFFERSON BLVD",
            "address_2": "SUITE 212",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044159",
            "telephone_number": "260-489-8898",
            "fax_number": "260-373-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST INDIANA COLON RECTAL SURGEONS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAIMAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "260-489-8898",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Colon & Rectal Surgery Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Colon & Rectal Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.