Provider Demographics
NPI:1730234071
Name:NORTHERN INDIANA NEONATAL ASSOCIATES, PC
Entity type:Organization
Organization Name:NORTHERN INDIANA NEONATAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BIEHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:260-639-3795
Mailing Address - Street 1:11234 MINNICH RD
Mailing Address - Street 2:ATTN JO HOFFMAN
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46816-9737
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3221 COVINGTON LAKE DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-2515
Practice Address - Country:US
Practice Address - Phone:260-639-3795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200373440AMedicaid