Michael T Isenberg, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

01024412 Issued in IN

Practice address

7900 W Jefferson Blvd
Suite 201
Fort Wayne, IN 46804-4128

Phone

(260) 969-7100

Fax

(260) 969-7264

NPI assigned

May 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1871546960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 W JEFFERSON BLVD",
            "address_2": "SUITE 201",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044128",
            "telephone_number": "260-969-7100",
            "fax_number": "260-969-7264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 W JEFFERSON BLVD",
            "address_2": "SUITE 201",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044128",
            "telephone_number": "260-969-7100",
            "fax_number": "260-969-7264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISENBERG",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01024412",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01024412A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100355800",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Wayne Isch, MA
• Olivia Isch
• Isd Renal Inc
• Isd Renal Inc
• Isd Renal Inc
• Edna O Isiorho, RN, APN
• Steven Ison
• Vatche A Israbian, MD
• Christine Marie Itt, PHARMD
• Iu Health Southwest Fort Wayne Ambulatory Surgery Center LLC

• Gastroenterology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Gastroenterology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; 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.