Bustamante, Blandine B
Bustamante, Blandine B is an individual health care provider with primary practice located at 2200 Randallia Dr , Ft Wayne IN 46805-4638. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Bustamante, Blandine B can be contacted via phone (260) 424-2195.Contact Information
Primary practice address
2200 Randallia Dr
Ft Wayne IN 46805-4638
Phone: (260) 424-2195
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 01042290A | Indiana |
Profile Details
| NPI number | 1093799546 |
|---|---|
| LBN Legal business name | Bustamante, Blandine B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 29th, 2005 |
| Last updated | Apr 29th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093799546 | NPPES |
| Indiana | MEDICAID | 200002580 |
Popular Providers
-
Mcbride, Ralph Craig
2200 Randallia Dr , Ft Wayne IN 46805-4638 -
Uschuplich, Vedran
2121 Lake Ave , Fort Wayne IN 46805-5100 -
Zhuang, Yi
11109 Parkview Plaza Dr , Fort Wayne IN 46845-1701 -
Muller, Marzena Wiacek
11109 Parkview Plaza Dr , Fort Wayne IN 46845-1701 -
Ellingson, Derek
7950 W Jefferson Blvd , Fort Wayne IN 46804-4140 -
Lee, Shuishih Sage
2200 Randallia Dr , Ft Wayne IN 46805-4638 -
Wan, Xiaoying
2200 Randallia Dr , Ft Wayne IN 46805-4638 -
Geng, Lili
7950 W Jefferson Blvd , Fort Wayne IN 46804-4140