Brandon Baccari
Brandon Baccari is a Student in an Organized Health Care Education/Training Program in Fort Wayne, Indiana. Licensed in Indiana. Registered with an NPI since 2019.
- Licensed in
- IN
- In the registry since
- 2019
- Specialties on file
- 2
Practice location Address checks out
12404 Lima Crossing DrFort Wayne, IN 46818
Phone: (260) 478-4201
Fax: (260) 458-3293
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Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X · Licence 02006419A (IN) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1588125330 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | March 26, 2019 |
| Last updated in NPPES | September 7, 2022 |
| Certification date | September 7, 2022 |
| Mailing address | 6920 Pointe Inverness Way Ste 200, Fort Wayne, IN 46804-7934 |
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