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Dr. Hassan Taki, MD
Specialist in Fort Wayne, Indiana
NPI 1114911807

Hassan Taki is a Specialist based in Fort Wayne, IN. Hassan Taki practices in Fort Wayne, IN and has the professional credentials of MD. The NPI Number for Hassan Taki is 1114911807 and holds a License No. 01042585 (Indiana).

The current practice location address for Hassan Taki is 4424 E State Blvd, Fort Wayne, IN and can be reached out via phone at 260-483-4433 and via fax at 260-483-4223.

Location: 4424 E State Blvd, Fort Wayne, IN, 46815-6917
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114911807
Provider Name
Hassan Taki
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
4424 E State Blvd, Fort Wayne, IN, 46815-6917
Phone Number
260-483-4433
Fax Number
260-483-4223
Provider Enumeration Date
09/08/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1924 01 IN PHYSCIANS HEALTH PLAN
3000054923 05 IN
1659549475 01 GROUP NPI
000000091432 01 IN BLUE CROSS/BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
4424 E State Blvd
City
Fort Wayne
State
Indiana
Zip
46815-6917
Phone Number
260-483-4433
Fax Number
260-483-4223
person
Provider Business Mailing Address Details
Address
4424 E State Blvd
City
Fort Wayne
State
Indiana
Zip
46815-6917
Phone Number
260-483-4433
Fax Number
260-483-4223
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
01042585 (Indiana)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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