Basic Information
| Provider Information | |||||||||
| NPI: | 1104002765 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADJEI | ||||||||
| FirstName: | FRANK | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3702 NEW VISION DR BLDG B | ||||||||
| Address2: | |||||||||
| City: | FORT WAYNE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 468451703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2602666013 | ||||||||
| FaxNumber: | 2604585831 | ||||||||
| Practice Location | |||||||||
| Address1: | 5110 N CLINTON ST | ||||||||
| Address2: | |||||||||
| City: | FORT WAYNE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 468255735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2604696605 | ||||||||
| FaxNumber: | 2609693066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2008 | ||||||||
| LastUpdateDate: | 04/30/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0101247085 | VA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 4301089509 | MI | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 01076767A | IN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.