Forefront Dermatology, S.C.
Organization Active NPI Dermatology Physician · Fort Wayne, IN
NPI 1881055069 · NPPES record last updated May 16, 2018
Key facts
- NPI
- 1881055069
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- Legal business name
- FOREFRONT DERMATOLOGY, S.C.
- Practice address
- 10620 Corporate Dr
Suite a
Fort Wayne, IN 46845 - Phone
- (260) 423-2567
- Fax
- (260) 420-2415
- NPI assigned
- Mar 15, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Betsy J Wernli, MD
- Title
- President
- Phone
- (920) 482-0671
Other NPIs on the same Medicare enrollment 24
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140425001640 | IN | Part B Supplier - Clinic/Group Practice | 3779471701 |
Receives reassigned benefits from 44 practitioners 24 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Kokomo, IN; Marion, IN; Mooresville, IN; Noblesville, IN; Salem, IN; Crown Point, IN; Scottsburg, IN; Seymour, IN… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | Yes |
Addresses
Primary practice location
10620 Corporate Dr
Suite a
Fort Wayne, IN 46845
Mailing address
801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9016
Other providers in Fort Wayne, IN
- Rebecca L Ford
- Robert Anthony Ford
- Tricia Louise Ford
- Cindy M Fordyce
- Forefront Dermatology SC
- Forensic Nursing Specialties, Inc
- Raphael Fredrick Forestieri
- Cory Lee Fornal
- Dana R Forrest
- Jeri Ann Forrest
All providers in Fort Wayne, IN · Dermatology Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.