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Pratyusha Tantravahi, DO
Student in an Organized Health Care Education/Training Program in Fort Wayne, Indiana
NPI 1295198414

Pratyusha Tantravahi is a Student in an Organized Health Care Education/Training Program based in Fort Wayne, IN. Pratyusha Tantravahi practices in Fort Wayne, IN and has the professional credentials of DO. The NPI Number for Pratyusha Tantravahi is 1295198414 and holds a License No. 02006015 (Indiana).

The current practice location address for Pratyusha Tantravahi is 11109 Parkview Plaza Dr, Fort Wayne, IN and can be reached out via phone at 260-266-2020 and via fax at 260-266-2009.

Location: 11109 Parkview Plaza Dr, Fort Wayne, IN, 46845
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1295198414
Provider Name
Pratyusha Tantravahi
Credential
DO
Provider Entity Type
Individual
Gender
Female
Address
11109 Parkview Plaza Dr, Fort Wayne, IN, 46845
Phone Number
260-266-2020
Fax Number
260-266-2009
Provider Enumeration Date
04/04/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
11109 Parkview Plaza Dr
City
Fort Wayne
State
Indiana
Zip
46845-1701
Phone Number
260-266-2020
Fax Number
260-266-2009
person
Provider Business Mailing Address Details
Address
11109 Parkview Plaza Dr
City
Fort Wayne
State
Indiana
Zip
46845-1701
Phone Number
260-266-2020
Fax Number
260-266-2009
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
02006015A (Indiana)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
02006015 (Indiana)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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